A new study suggests that direct-acting antiviral therapy is safe and effective in patients with chronic kidney disease and hepatitis C virus (HCV) infection. The study, which is seen in an upcoming issue of the Clinical Journal of the American Society of Nephrology, also discovered that treatment could help improve of the patients’ kidney functions.
To figure out the safety and efficacy of sofosbuvir, a potent direct-acting antiviral therapy, in patients with CKD, Meghan Sise, MD, MS, from Massachusetts General Hospital and her colleagues studied 98 patients with stages 1-3 CKD who received sofosbuvir-based therapy in a big health care system.
Overall sustained virologic response was 81%, and the average kidney function while on the treatment was steady. Patients with more advanced CKD were more probable to be cured of HCV infection than those with mild CKD. Also, patients with advanced CKD who were cured of HCV infection displayed an improvement in their kidney function after treatment. Sofosbuvir was considerably well tolerated: adverse events were common (81%), but serious adverse events (17%) and treatment discontinuations (8%) were uncommon. Next, there was no detectable effect of the degree of CKD on the pace of adverse events.
Additional studies are required to determine if eradication of HCV with direct-acting antiviral therapy halts or prevents progression to end stage kidney disease in patients with HCV and CKD.
“The use of direct-acting antiviral therapy in patients with Hepatitis C infection has transformed the illness into a curable one. This study shows that these medications can be safely and effectively used in patients with stage 1-3 kidney disease,” quoted Sise.
In an associated editorial, Dr. Richard Johnson, from the University of Colorado and Dr. Michiko Shimada, Hirosaki University Graduate School of Medicine, reported their findings. They discovered that there are other antiviral drugs that are effective in patients with HCV and CKD, and not like sofosbuvir, they are not eradicated by the kidneys. In result, additional research on the effects of a variety of antivirals in patients with compromised kidney functions is required. “We predict that HCV, like hepatitis B virus and HIV, will slowly disappear as a major medical problem for patients with renal disease,” they stated.