The Novel Finding of Dynamic Change in eGFR Up to One Year after End of Treatment in HCV-Infected Patients Receiving Sofosbuvir and Velpatasvir
<b><i>Background:</i></b> The results of long-term renal evolution in HCV-infected patients using sofosbuvir and velpatasvir (SOF/VEL), with or without ribavirin (RBV), are lacking. <b><i>Aims:</i></b> We evaluated the renal safety for HCV-infected pat...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-02-01
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| Series: | Viruses |
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| Online Access: | https://www.mdpi.com/1999-4915/14/2/362 |
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| author | Cheng-Kun Wu Li-Wei Chen Te-Sheng Chang Shui-Yi Tung Chun-Yen Lin Chao-Hung Hung Sheng-Nan Lu Chih-Lang Lin Chien-Hung Chen Chao-Wei Hsu Tsung-Hui Hu I-Shyan Sheen |
| author_facet | Cheng-Kun Wu Li-Wei Chen Te-Sheng Chang Shui-Yi Tung Chun-Yen Lin Chao-Hung Hung Sheng-Nan Lu Chih-Lang Lin Chien-Hung Chen Chao-Wei Hsu Tsung-Hui Hu I-Shyan Sheen |
| author_sort | Cheng-Kun Wu |
| collection | DOAJ |
| description | <b><i>Background:</i></b> The results of long-term renal evolution in HCV-infected patients using sofosbuvir and velpatasvir (SOF/VEL), with or without ribavirin (RBV), are lacking. <b><i>Aims:</i></b> We evaluated the renal safety for HCV-infected patients receiving SOF/VEL. <b><i>Methods:</i></b> 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. <b><i>Results:</i></b> 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 m<sup>2</sup>) 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, <i>p</i> = 0.001) was a significant risk factor at SVR24, while diabetes mellitus (OR = 2.765, 95% CI: 1.104–6.922, <i>p</i> = 0.030) and the use of RBV (OR = 3.143, 95% CI: 1.047–9.435, <i>p</i> = 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. <b><i>Conclusions:</i></b> 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 m<sup>2</sup>) 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. |
| first_indexed | 2024-03-09T20:52:00Z |
| format | Article |
| id | doaj.art-d822ef8e42fd4d7ba281606490b8673a |
| institution | Directory Open Access Journal |
| issn | 1999-4915 |
| language | English |
| last_indexed | 2024-03-09T20:52:00Z |
| publishDate | 2022-02-01 |
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| series | Viruses |
| spelling | doaj.art-d822ef8e42fd4d7ba281606490b8673a2023-11-23T22:31:41ZengMDPI AGViruses1999-49152022-02-0114236210.3390/v14020362The Novel Finding of Dynamic Change in eGFR Up to One Year after End of Treatment in HCV-Infected Patients Receiving Sofosbuvir and VelpatasvirCheng-Kun Wu0Li-Wei Chen1Te-Sheng Chang2Shui-Yi Tung3Chun-Yen Lin4Chao-Hung Hung5Sheng-Nan Lu6Chih-Lang Lin7Chien-Hung Chen8Chao-Wei Hsu9Tsung-Hui Hu10I-Shyan Sheen11Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 83301, TaiwanDivision of Hepato-Gastroenterology, Department of Internal Medicine, Keelung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Keelung 20420, TaiwanDivision of Hepato-Gastroenterology, Department of Internal Medicine, Chiayi Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Chiayi 613016, TaiwanDivision of Hepato-Gastroenterology, Department of Internal Medicine, Chiayi Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Chiayi 613016, TaiwanDivision of Hepato-Gastroenterology, Department of Internal Medicine, Linkou Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Linkou 333423, TaiwanDivision of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 83301, TaiwanDivision of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 83301, TaiwanDivision of Hepato-Gastroenterology, Department of Internal Medicine, Keelung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Keelung 20420, TaiwanDivision of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 83301, TaiwanDivision of Hepato-Gastroenterology, Department of Internal Medicine, Linkou Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Linkou 333423, TaiwanDivision of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 83301, TaiwanDivision of Hepato-Gastroenterology, Department of Internal Medicine, Linkou Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Linkou 333423, Taiwan<b><i>Background:</i></b> The results of long-term renal evolution in HCV-infected patients using sofosbuvir and velpatasvir (SOF/VEL), with or without ribavirin (RBV), are lacking. <b><i>Aims:</i></b> We evaluated the renal safety for HCV-infected patients receiving SOF/VEL. <b><i>Methods:</i></b> 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. <b><i>Results:</i></b> 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 m<sup>2</sup>) 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, <i>p</i> = 0.001) was a significant risk factor at SVR24, while diabetes mellitus (OR = 2.765, 95% CI: 1.104–6.922, <i>p</i> = 0.030) and the use of RBV (OR = 3.143, 95% CI: 1.047–9.435, <i>p</i> = 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. <b><i>Conclusions:</i></b> 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 m<sup>2</sup>) 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.https://www.mdpi.com/1999-4915/14/2/362direct-acting antiviralshepatitis C virussofosbuvir and velpatasvirrenal function |
| spellingShingle | Cheng-Kun Wu Li-Wei Chen Te-Sheng Chang Shui-Yi Tung Chun-Yen Lin Chao-Hung Hung Sheng-Nan Lu Chih-Lang Lin Chien-Hung Chen Chao-Wei Hsu Tsung-Hui Hu I-Shyan Sheen The Novel Finding of Dynamic Change in eGFR Up to One Year after End of Treatment in HCV-Infected Patients Receiving Sofosbuvir and Velpatasvir Viruses direct-acting antivirals hepatitis C virus sofosbuvir and velpatasvir renal function |
| title | The Novel Finding of Dynamic Change in eGFR Up to One Year after End of Treatment in HCV-Infected Patients Receiving Sofosbuvir and Velpatasvir |
| title_full | The Novel Finding of Dynamic Change in eGFR Up to One Year after End of Treatment in HCV-Infected Patients Receiving Sofosbuvir and Velpatasvir |
| title_fullStr | The Novel Finding of Dynamic Change in eGFR Up to One Year after End of Treatment in HCV-Infected Patients Receiving Sofosbuvir and Velpatasvir |
| title_full_unstemmed | The Novel Finding of Dynamic Change in eGFR Up to One Year after End of Treatment in HCV-Infected Patients Receiving Sofosbuvir and Velpatasvir |
| title_short | The Novel Finding of Dynamic Change in eGFR Up to One Year after End of Treatment in HCV-Infected Patients Receiving Sofosbuvir and Velpatasvir |
| title_sort | novel finding of dynamic change in egfr up to one year after end of treatment in hcv infected patients receiving sofosbuvir and velpatasvir |
| topic | direct-acting antivirals hepatitis C virus sofosbuvir and velpatasvir renal function |
| url | https://www.mdpi.com/1999-4915/14/2/362 |
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