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Observational Study
. 2025 May 16;25(1):706.
doi: 10.1186/s12879-025-10947-x.

Impact of hepatitis C virus genotype on the efficacy of the direct-acting antivirals in chronic kidney disease patients in West Bengal, India

Sagnik Bakshi #  1 , Supradip Dutta #  1 , Aritra Biswas  1 , Raina Das  1 , Shreyasi Nath  1 , Anwesha Ghosh  1 , Upasana Baskey  1 , Provash Chandra Sadhukhan  2
Affiliations
Observational Study

Impact of hepatitis C virus genotype on the efficacy of the direct-acting antivirals in chronic kidney disease patients in West Bengal, India

Sagnik Bakshi et al. BMC Infect Dis. .

Abstract

Background: Hepatitis C virus (HCV) infection increases the risk of mortality and morbidity among chronic kidney disease (CKD) patients. However, the advancement of HCV treatment has made this viral infection curable. Thus, the main objective of this study was to comprehend the HCV genotype (GT) distribution and the efficacy of direct-acting antivirals (DAAs) among CKD patients in West Bengal.

Methods: Over five years (January 2017 to December 2021), 310 HCV sero-reactive patients were enrolled in this observational prospective study. HCV RNA was quantified using qRT-PCR. The partial amplification of the core (405 bp) and NS5B (389 bp) region was performed by nested RT-PCR followed by Sanger sequencing for HCV genotype analysis using the NCBI genotyping tool. The phylogenetic tree was constructed using the MEGA-X tool.

Results: The occurrence of HCV RNA positivity was 50.64% (n = 157), and of these 157 patients, 141 (89.81%) completed the DAAs treatment. The most important observation of the study was the prevalence of uncommon HCV genotype GT-1c (67.52%) followed by 1a, 4a, 3a, 1b, and 3b among CKD patients. The overall DAAs efficacy between January 2017 and December 2018 was ~ 97%, and in January 2019 and December 2021, ~ 95% among CKD patients. At the same time, in these two phases, DAAs efficacy among GT-1c-infected CKD patients was ˜ 96% and ˜ 93%, respectively.

Conclusions: The prevalence of GT-1c among CKD patients was unusual in this geographic region. The overall efficacy of DAAs among the CKD population was encouraging. However, the downtrend of the DAAs efficacy in GT-1c may increase concern among this high-risk group in the future.

Clinical trial: Not applicable.

Keywords: Chronic kidney disease (CKD); Direct-acting antivirals (DAAs); HCV genotype (GT); Hepatitis C virus (HCV).

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Conflict of interest statement

Declarations. Ethics approval and consent from the participant: The study was conducted according to the guidelines of the Declaration of Helsinki and approved by the Institutional Ethics Committee of the Indian Council of Medical Research-National Institute of Cholera and Enteric Diseases (ICMR-NICED; recently the name changed to ICMR-NIRBI), Kolkata (Approval number: A-1/2016-IEC; date of approval: 03.10.2016). Informed consent was obtained from all subjects involved in this study. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1a
Fig. 1a
A donut pie chart shows the distribution of HCV genotypes in CKD patients.
Fig. 1b
Fig. 1b
[A]: A phylogenetic tree of partial core sequences of all HCV genotypes isolated among CKD patients
Fig. 1b
Fig. 1b
[B]: A phylogenetic tree of partial NS5B sequences of all HCV genotypes isolated among CKD patients
Fig. 2a
Fig. 2a
The distribution of direct-acting antivirals (DAAs) treatment recommended from 2017 to 2021 among CKD patients
Fig. 2b
Fig. 2b
The comparative analysis of HCV genotype distribution of CKD patients who underwent DAAs treatment
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