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. 2020 Oct;26(4):554-561.
doi: 10.3350/cmh.2020.0058. Epub 2020 Aug 28.

Use of glecaprevir/pibrentasvir in patients with chronic hepatitis C virus infection and severe renal impairment

Desmond Y H Yap  1 , Kevin S H Liu  2 , Yu-Chun Hsu  3 , Grace L H Wong  4 , Ming-Chang Tsai  5 , Chien-Hung Chen  6 , Ching-Sheng Hsu  7 , Yee Tak Hui  8 , Michael K K Li  9 , Chen-Hua Liu  10 , Yee-Man Kan  11 , Ming-Lung Yu  12 , Man-Fung Yuen  2
Affiliations

Use of glecaprevir/pibrentasvir in patients with chronic hepatitis C virus infection and severe renal impairment

Desmond Y H Yap et al. Clin Mol Hepatol. 2020 Oct.

Abstract

Background/aims: Data on treatment efficacy and safety of glecaprevir/pibrentasvir (GLE/PIB) for chronic hepatitis C virus (HCV) infection in Asian patients with severe renal impairment are limited. This study aimed to study the treatment and side effects of GLE/PIB in these patients infected with non-1 genotype (GT) HCV.

Methods: We prospectively recruited patients with Child's A cirrhosis and eGFR <30 mL/min/1.73 m2 in Hong Kong and Taiwan during 2017-2018 to receive GLE/PIB treatment.

Results: Twenty-one patients (GT2, n=7; GT3, n=6; and GT6, n=8) received GLE/PIB for 11.2±1.8 weeks. All except one were treatment-naïve. GLE/PIB was initiated in 16 patients while on dialysis (seven on peritoneal dialysis [PD] and nine on hemodialysis) and in five patients before dialysis. One patient died of PD-related peritonitis during treatment and two were lost to follow up. The SVR12 rate in the remaining 18 patients was 100%. All patients achieved undetectable levels at 4-, 12-, 24- and 48-week after treatment. Patients with deranged alanine aminotransferase showed normalization after 4 weeks and the response was sustained for 48 weeks. No significant adverse event was observed.

Conclusion: GLE/PIB treatment was associated with high efficacy and tolerability in HCV-infected patients with severe renal impairment.

Keywords: Glecaprevir and pibrentasvir; Hepatitis C; Renal insufficiency.

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Conflict of interest statement

Conflicts of Interest: The authors have no conflicts to disclose.

Figures

Figure 1.
Figure 1.
Changes in (A) HCV RNA, (B) ALT, and (C) renal function in patients with severe renal impairment and received glecaprevair/pibrentasvir treatment. HCV, hepatitis C virus; ALT, alanine aminotransferase; eGFR, estimated glomerular filtration rate.
Figure 2.
Figure 2.
The rate of sustained virological response (SVR) as analysed per protocol or by intention to treat (ITT).
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