Safety and effectiveness of direct-acting antivirals in patients with chronic hepatitis C and chronic kidney disease
Background/Aims To evaluate the effectiveness and safety of direct acting antivirals (DAAs) available in chronic kidney disease (CKD) patients with hepatitis C virus (HCV) infection in Korea. Methods In a retrospective, multicenter cohort study, 362 patients were enrolled from 2015 to 2019. The effe...
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| Format: | Article |
| Language: | English |
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The Korean Association of Internal Medicine
2022-09-01
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| Series: | The Korean Journal of Internal Medicine |
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| Online Access: | http://kjim.org/upload/pdf/kjim-2021-486.pdf |
| _version_ | 1818067419850080256 |
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| author | Ji Eun Ryu Myeong Jun Song Seok-Hwan Kim Jung Hyun Kwon Sun Hong Yoo Soon Woo Nam Hee Chul Nam Hee Yeon Kim Chang Wook Kim Hyun Yang Si Hyun Bae Do Seon Song U Im Chang Jin Mo Yang Sung Won Lee Hae Lim Lee Soon Kyu Lee Pil Soo Sung Jeong Won Jang Jong Young Choi Seung Kew Yoon |
| author_facet | Ji Eun Ryu Myeong Jun Song Seok-Hwan Kim Jung Hyun Kwon Sun Hong Yoo Soon Woo Nam Hee Chul Nam Hee Yeon Kim Chang Wook Kim Hyun Yang Si Hyun Bae Do Seon Song U Im Chang Jin Mo Yang Sung Won Lee Hae Lim Lee Soon Kyu Lee Pil Soo Sung Jeong Won Jang Jong Young Choi Seung Kew Yoon |
| author_sort | Ji Eun Ryu |
| collection | DOAJ |
| description | Background/Aims To evaluate the effectiveness and safety of direct acting antivirals (DAAs) available in chronic kidney disease (CKD) patients with hepatitis C virus (HCV) infection in Korea. Methods In a retrospective, multicenter cohort study, 362 patients were enrolled from 2015 to 2019. The effectiveness and safety of DAAs including glecaprevir/pibrentasvir, sofosubvir/ribavirin, ledipasvir/sofosbuvir, and daclatasvir/asunaprevir were analyzed for patients according to CKD stage. We evaluated sustained virologic response at week 12 after treatment (SVR12) as primary endpoint. The effectiveness and safety were also evaluated according to CKD stage. Results Among 362 patients, 307 patients completed DAAs treatment and follow-up period after end of treatment. The subjects comprised 87 patients (62 with CKD stage 3 and 25 with CKD stage (4–5), of whom 22 were undergoing hemodialysis). HCV patients with CKD stage 1 and 2 (estimated glomerular filtration rate [eGFR] ≥ 60 mL/min/1.73 m2) showed SVR12 of 97.2% and 95.4% respectively. SVR12 of CKD stage 3 and 4–5 (eGFR < 60 mL/min/1.73 m2) patients was 91.9% and 91.6% respectively. Patients undergoing hemodialysis achieved SVR12 (90.9%). Treatment failure of DAAs in stage 1, 2, 3, and 4–5 was 2.8%, 2.7%, 1.6%, and 4%. DAAs showed good safety profile and did not affect deterioration of renal function. Conclusions DAAs shows comparable SVR12 and safety in CKD patients (stage 3, 4, and 5) with HCV compared with patients with stage 1 and 2. The effectiveness and safety of DAAs may be related to the treatment duration. Therefore, it is important to select adequate regimens of DAAs and to increase treatment adherence. |
| first_indexed | 2024-12-10T15:23:23Z |
| format | Article |
| id | doaj.art-56e49e1477b041b4b68e85e9a5d62527 |
| institution | Directory Open Access Journal |
| issn | 1226-3303 2005-6648 |
| language | English |
| last_indexed | 2024-12-10T15:23:23Z |
| publishDate | 2022-09-01 |
| publisher | The Korean Association of Internal Medicine |
| record_format | Article |
| series | The Korean Journal of Internal Medicine |
| spelling | doaj.art-56e49e1477b041b4b68e85e9a5d625272022-12-22T01:43:36ZengThe Korean Association of Internal MedicineThe Korean Journal of Internal Medicine1226-33032005-66482022-09-0137595896810.3904/kjim.2021.486170717Safety and effectiveness of direct-acting antivirals in patients with chronic hepatitis C and chronic kidney diseaseJi Eun Ryu0Myeong Jun Song1Seok-Hwan Kim2Jung Hyun Kwon3Sun Hong Yoo4Soon Woo Nam5Hee Chul Nam6Hee Yeon Kim7Chang Wook Kim8Hyun Yang9Si Hyun Bae10Do Seon Song11U Im Chang12Jin Mo Yang13Sung Won Lee14Hae Lim Lee15Soon Kyu Lee16Pil Soo Sung17Jeong Won Jang18Jong Young Choi19Seung Kew Yoon20Division of Hepatology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, KoreaDivision of Hepatology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, KoreaDivision of Hepatology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, KoreaDivision of Hepatology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, KoreaDivision of Hepatology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, KoreaDivision of Hepatology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, KoreaDivision of Hepatology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, KoreaDivision of Hepatology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, KoreaDivision of Hepatology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, KoreaDivision of Hepatology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, KoreaDivision of Hepatology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, KoreaDivision of Hepatology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, KoreaDivision of Hepatology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, KoreaDivision of Hepatology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, KoreaDivision of Hepatology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, KoreaDivision of Hepatology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, KoreaDivision of Hepatology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, KoreaDivision of Hepatology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, KoreaDivision of Hepatology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, KoreaDivision of Hepatology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, KoreaDivision of Hepatology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, KoreaBackground/Aims To evaluate the effectiveness and safety of direct acting antivirals (DAAs) available in chronic kidney disease (CKD) patients with hepatitis C virus (HCV) infection in Korea. Methods In a retrospective, multicenter cohort study, 362 patients were enrolled from 2015 to 2019. The effectiveness and safety of DAAs including glecaprevir/pibrentasvir, sofosubvir/ribavirin, ledipasvir/sofosbuvir, and daclatasvir/asunaprevir were analyzed for patients according to CKD stage. We evaluated sustained virologic response at week 12 after treatment (SVR12) as primary endpoint. The effectiveness and safety were also evaluated according to CKD stage. Results Among 362 patients, 307 patients completed DAAs treatment and follow-up period after end of treatment. The subjects comprised 87 patients (62 with CKD stage 3 and 25 with CKD stage (4–5), of whom 22 were undergoing hemodialysis). HCV patients with CKD stage 1 and 2 (estimated glomerular filtration rate [eGFR] ≥ 60 mL/min/1.73 m2) showed SVR12 of 97.2% and 95.4% respectively. SVR12 of CKD stage 3 and 4–5 (eGFR < 60 mL/min/1.73 m2) patients was 91.9% and 91.6% respectively. Patients undergoing hemodialysis achieved SVR12 (90.9%). Treatment failure of DAAs in stage 1, 2, 3, and 4–5 was 2.8%, 2.7%, 1.6%, and 4%. DAAs showed good safety profile and did not affect deterioration of renal function. Conclusions DAAs shows comparable SVR12 and safety in CKD patients (stage 3, 4, and 5) with HCV compared with patients with stage 1 and 2. The effectiveness and safety of DAAs may be related to the treatment duration. Therefore, it is important to select adequate regimens of DAAs and to increase treatment adherence.http://kjim.org/upload/pdf/kjim-2021-486.pdfrenal insufficiencychronichepatitis csustained virologic response |
| spellingShingle | Ji Eun Ryu Myeong Jun Song Seok-Hwan Kim Jung Hyun Kwon Sun Hong Yoo Soon Woo Nam Hee Chul Nam Hee Yeon Kim Chang Wook Kim Hyun Yang Si Hyun Bae Do Seon Song U Im Chang Jin Mo Yang Sung Won Lee Hae Lim Lee Soon Kyu Lee Pil Soo Sung Jeong Won Jang Jong Young Choi Seung Kew Yoon Safety and effectiveness of direct-acting antivirals in patients with chronic hepatitis C and chronic kidney disease The Korean Journal of Internal Medicine renal insufficiency chronic hepatitis c sustained virologic response |
| title | Safety and effectiveness of direct-acting antivirals in patients with chronic hepatitis C and chronic kidney disease |
| title_full | Safety and effectiveness of direct-acting antivirals in patients with chronic hepatitis C and chronic kidney disease |
| title_fullStr | Safety and effectiveness of direct-acting antivirals in patients with chronic hepatitis C and chronic kidney disease |
| title_full_unstemmed | Safety and effectiveness of direct-acting antivirals in patients with chronic hepatitis C and chronic kidney disease |
| title_short | Safety and effectiveness of direct-acting antivirals in patients with chronic hepatitis C and chronic kidney disease |
| title_sort | safety and effectiveness of direct acting antivirals in patients with chronic hepatitis c and chronic kidney disease |
| topic | renal insufficiency chronic hepatitis c sustained virologic response |
| url | http://kjim.org/upload/pdf/kjim-2021-486.pdf |
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