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. 2022 Feb 10;14(2):362.
doi: 10.3390/v14020362.

The Novel Finding of Dynamic Change in eGFR Up to One Year after End of Treatment in HCV-Infected Patients Receiving Sofosbuvir and Velpatasvir

Cheng-Kun Wu  1 , Li-Wei Chen  2 , Te-Sheng Chang  3 , Shui-Yi Tung  3 , Chun-Yen Lin  4 , Chao-Hung Hung  1 , Sheng-Nan Lu  1 , Chih-Lang Lin  2 , Chien-Hung Chen  1 , Chao-Wei Hsu  4 , Tsung-Hui Hu  1 , I-Shyan Sheen  4
Affiliations

The Novel Finding of Dynamic Change in eGFR Up to One Year after End of Treatment in HCV-Infected Patients Receiving Sofosbuvir and Velpatasvir

Cheng-Kun Wu et al. Viruses. .

Abstract

Background: The results of long-term renal evolution in HCV-infected patients using sofosbuvir and velpatasvir (SOF/VEL), with or without ribavirin (RBV), are lacking. Aims: We evaluated the renal safety for HCV-infected patients receiving SOF/VEL. Methods: Between 1 June 2019 and 6 July 2020, we included 594 HCV-infected patients receiving SOF/VEL +/- RBV for 12 weeks in Taiwan. Viral eradication rate (defined by sustained virological response at week 12 post-treatment; SVR12) and changes to renal function were considered. Results: SVR12 was achieved in 99.3% (590/594) upon per-protocol analysis. Patients saw improved hepatobiliary function and fibrosis after the start of SOF/VEL therapy. For renal function, those with baseline estimated glomerular filtration rate (eGFR) ≥ 60 (mL/min/1.73 m2) experienced transient on-treatment reduction in renal function that improved upon ending treatment, but recurrent eGFR degradation during one-year follow-up. The use of RBV (OR = 5.200, 95% CI: 1.983-13.634, p = 0.001) was a significant risk factor at SVR24, while diabetes mellitus (OR = 2.765, 95% CI: 1.104-6.922, p = 0.030) and the use of RBV (OR = 3.143, 95% CI: 1.047-9.435, p = 0.041) were identified as significant risk factors of worsening renal function at SVR48. SOF/VEL did not worsen renal function among those with stage 4-5 chronic kidney disease (CKD) who were not receiving dialysis. Conclusions: A trend of decline in eGFR at 1 year after SOF/VEL treatment was observed among diabetic patients with baseline eGFR ≥ 60 (mL/min/1.73 m2) and concomitant use of RBV. The close monitoring of renal function is warranted. Further study should be conducted in order to weigh the risks and benefit of RBV.

Keywords: direct-acting antivirals; hepatitis C virus; renal function; sofosbuvir and velpatasvir.

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Conflict of interest statement

The authors declare no conflict of interest related to the study.

Figures

Figure 1
Figure 1
The dynamic changes in laboratory data among enrolled patients who received 12 weeks of SOF/VEL-based therapy.
Figure 2
Figure 2
Evolution of eGFR among enrolled patients who received 12 weeks of SOF/VEL-based therapy.
See this image and copyright information in PMC

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