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. 2017 Dec 28;9(36):1352-1360.
doi: 10.4254/wjh.v9.i36.1352.

Impact of sustained virologic response on chronic kidney disease progression in hepatitis C

Elizabeth S Aby  1 , Tien S Dong  1 , Jenna Kawamoto  1 , Joseph R Pisegna  1 , Jihane N Benhammou  2
Affiliations

Impact of sustained virologic response on chronic kidney disease progression in hepatitis C

Elizabeth S Aby et al. World J Hepatol. .

Abstract

Aim: To determine how sustained virological response at 12 wk (SVR12) with direct acting antivirals (DAAs) for the treatment of hepatitis C virus (HCV) infection affects chronic kidney disease (CKD) progression.

Methods: A retrospective analysis was performed in patients aged ≥ 18 years treated for HCV with DAAs at the VA Greater Los Angeles Healthcare System from 2014-2016. The treatment group was compared to patients with HCV from 2011-2013 who did not undergo HCV treatment, prior to the introduction of DAAs; the control group was matched to the study group in terms of age, gender, and ethnicity. Analysis of variance and co-variance was performed to compare means between SVR12 subgroups adjusting for co-variates.

Results: Five hundred and twenty-three patients were evaluated. When comparing the rate of change in estimated glomerular filtration rate (eGFR) one-year after HCV treatment to one-year before treatment, patients who achieved SVR12 had a decline in GFR of 3.1 mL/min ± 0.75 mL/min per 1.73 m2 compared to a decline in eGFR of 11.0 mL/min ± 2.81 mL/min per 1.73 m2 in patients who did not achieve SVR12 (P = 0.002). There were no significant clinical differences between patients who achieved SVR12 compared to those who did not in terms of cirrhosis, treatment course, treatment experience, CKD stage prior to treatment, diuretic use or other co-morbidities. The decline in eGFR in those with untreated HCV over 2 years was 2.8 mL/min ± 1.0 mL/min per 1.73 m2, which was not significantly different from the eGFR decline noted in HCV-treated patients who achieved SVR12 (P = 0.43).

Conclusion: Patients who achieve SVR12 have a lesser decline in renal function, but viral eradication in itself may not be associated improvement in renal disease progression.

Keywords: Chronic kidney disease; Direct-acting antivirals; End stage renal disease; Hepatitis C; Sustained virological response.

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Conflict of interest statement

Conflict-of-interest statement: The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Rate of change in glomerular filtration rate one-year after hepatitis C virus treatment compared to one-year before treatment in relation to achievement of sustained virological response at 12 wk (P = 0.002). GFR: Glomerular filtration rate; SVR12: Sustained virological response at 12 wk following therapy.
Figure 2
Figure 2
Rate of change in glomerular filtration rate one-year after hepatitis C virus treatment compared to one-year before treatment in relation to achievement of sustained virological response at 12 wk separated by genotype. GFR: Glomerular filtration rate; SVR12: Sustained virological response at 12 wk following therapy.
Figure 3
Figure 3
Rate of change in glomerular filtration rate one-year after hepatitis C virus treatment compared to one-year before treatment in relation to achievement of sustained virological response at 12 wk separated by hepatitis C virus treatment type. GFR: Glomerular filtration rate; SVR12: Sustained virological response at 12 wk following therapy; HCV: Hepatitis C virus.
See this image and copyright information in PMC

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