Glomerular filtration rate change during chronic hepatitis C treatment with Sofosbuvir/Ledipasvir in HCV/HIV Coinfected patients treated with Tenofovir and a boosted protease inhibitor: an observational prospective study
Abstract Introduction Concomitant use of ledipasvir and boosted protease inhibitors (PIs) may increase the risk of tenofovir (TDF) nephrotoxicity, since both these drugs increase TDF levels. Our aim was to evaluate glomerular filtration rate (eGFR) evolution during HCV treatment with sofosbuvir/ledi...
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BMC
2018-08-01
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| Series: | BMC Infectious Diseases |
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| Online Access: | http://link.springer.com/article/10.1186/s12879-018-3278-3 |
| _version_ | 1818822339896279040 |
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| author | Cristina Aurora São Pedro Soeiro Celina Andreia Melo Gonçalves Marta Sofia Correia Marques Maria Josefina Vazquez Méndez Ana Paula Ribeiro Almeida Tavares Ana Maria Lacerda Morgado Fernandes de Carvalho de Aboim Horta Rui Manuel do Rosário Sarmento-Castro |
| author_facet | Cristina Aurora São Pedro Soeiro Celina Andreia Melo Gonçalves Marta Sofia Correia Marques Maria Josefina Vazquez Méndez Ana Paula Ribeiro Almeida Tavares Ana Maria Lacerda Morgado Fernandes de Carvalho de Aboim Horta Rui Manuel do Rosário Sarmento-Castro |
| author_sort | Cristina Aurora São Pedro Soeiro |
| collection | DOAJ |
| description | Abstract Introduction Concomitant use of ledipasvir and boosted protease inhibitors (PIs) may increase the risk of tenofovir (TDF) nephrotoxicity, since both these drugs increase TDF levels. Our aim was to evaluate glomerular filtration rate (eGFR) evolution during HCV treatment with sofosbuvir/ledipasvir (SOF/LDV) in HCV/HIV coinfected patients, according to their antiretroviral treatment (ARV). Methods Observational prospective study of HCV/HIV coinfected patients treated with SOF/LDV. eGFR evolution was evaluated during and 12 weeks after HCV treatment. Patients were categorized in three groups based on ARV regimen: non TDF, non-boosted TDF and TDF + boosted PI. Results We included 273 patients: 145 were receiving a non-TDF regimen, 78 a non-boosted TDF scheme and 50 were receiving TDF + boosted PI. We observed a statistically significant decrease in eGFR during treatment in all groups (non TDF p = 0.03, 95%CI [0.23–3.86], non-boosted TDF p < 0.01, 95%CI [3.36–7.44], TDF + PI p = 0.01, 95%CI [1.09–7.53]). The decrease was more pronounced in those receiving unboosted TDF (− 5.40 ml/min/1.73m2), but differences in eGFR decrease between the three groups were small and not statistically different (p = 0.06). eGFR decrease was greater in patients treated for 24 weeks (p = 0.009) and in cirrhotic patients (p = 0.036). At the end of follow up a recovery of eGFR was observed in all groups. Conclusion We observed a significant decrease in eGFR during treatment in all study groups, that was small and reversible after SOF/LDV discontinuation. TDF was not associated with an increase in renal toxicity. |
| first_indexed | 2024-12-18T23:22:31Z |
| format | Article |
| id | doaj.art-f602c70ee86c4747b6d8fb5b56685aef |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-12-18T23:22:31Z |
| publishDate | 2018-08-01 |
| publisher | BMC |
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| series | BMC Infectious Diseases |
| spelling | doaj.art-f602c70ee86c4747b6d8fb5b56685aef2022-12-21T20:47:55ZengBMCBMC Infectious Diseases1471-23342018-08-011811610.1186/s12879-018-3278-3Glomerular filtration rate change during chronic hepatitis C treatment with Sofosbuvir/Ledipasvir in HCV/HIV Coinfected patients treated with Tenofovir and a boosted protease inhibitor: an observational prospective studyCristina Aurora São Pedro Soeiro0Celina Andreia Melo Gonçalves1Marta Sofia Correia Marques2Maria Josefina Vazquez Méndez3Ana Paula Ribeiro Almeida Tavares4Ana Maria Lacerda Morgado Fernandes de Carvalho de Aboim Horta5Rui Manuel do Rosário Sarmento-Castro6Infectious Diseases Department, Centro Hospitalar do PortoInfectious Diseases Department, Centro Hospitalar do PortoInfectious Diseases Department, Centro Hospitalar do PortoInfectious Diseases Department, Centro Hospitalar do PortoInfectious Diseases Department, Centro Hospitalar do PortoInfectious Diseases Department, Centro Hospitalar do PortoInfectious Diseases Department, Centro Hospitalar do PortoAbstract Introduction Concomitant use of ledipasvir and boosted protease inhibitors (PIs) may increase the risk of tenofovir (TDF) nephrotoxicity, since both these drugs increase TDF levels. Our aim was to evaluate glomerular filtration rate (eGFR) evolution during HCV treatment with sofosbuvir/ledipasvir (SOF/LDV) in HCV/HIV coinfected patients, according to their antiretroviral treatment (ARV). Methods Observational prospective study of HCV/HIV coinfected patients treated with SOF/LDV. eGFR evolution was evaluated during and 12 weeks after HCV treatment. Patients were categorized in three groups based on ARV regimen: non TDF, non-boosted TDF and TDF + boosted PI. Results We included 273 patients: 145 were receiving a non-TDF regimen, 78 a non-boosted TDF scheme and 50 were receiving TDF + boosted PI. We observed a statistically significant decrease in eGFR during treatment in all groups (non TDF p = 0.03, 95%CI [0.23–3.86], non-boosted TDF p < 0.01, 95%CI [3.36–7.44], TDF + PI p = 0.01, 95%CI [1.09–7.53]). The decrease was more pronounced in those receiving unboosted TDF (− 5.40 ml/min/1.73m2), but differences in eGFR decrease between the three groups were small and not statistically different (p = 0.06). eGFR decrease was greater in patients treated for 24 weeks (p = 0.009) and in cirrhotic patients (p = 0.036). At the end of follow up a recovery of eGFR was observed in all groups. Conclusion We observed a significant decrease in eGFR during treatment in all study groups, that was small and reversible after SOF/LDV discontinuation. TDF was not associated with an increase in renal toxicity.http://link.springer.com/article/10.1186/s12879-018-3278-3Co-infection HIV/HCVHCV treatmentSofosbuvir/ledipasvirRenal toxicityTenofovirProtease inhibitor |
| spellingShingle | Cristina Aurora São Pedro Soeiro Celina Andreia Melo Gonçalves Marta Sofia Correia Marques Maria Josefina Vazquez Méndez Ana Paula Ribeiro Almeida Tavares Ana Maria Lacerda Morgado Fernandes de Carvalho de Aboim Horta Rui Manuel do Rosário Sarmento-Castro Glomerular filtration rate change during chronic hepatitis C treatment with Sofosbuvir/Ledipasvir in HCV/HIV Coinfected patients treated with Tenofovir and a boosted protease inhibitor: an observational prospective study BMC Infectious Diseases Co-infection HIV/HCV HCV treatment Sofosbuvir/ledipasvir Renal toxicity Tenofovir Protease inhibitor |
| title | Glomerular filtration rate change during chronic hepatitis C treatment with Sofosbuvir/Ledipasvir in HCV/HIV Coinfected patients treated with Tenofovir and a boosted protease inhibitor: an observational prospective study |
| title_full | Glomerular filtration rate change during chronic hepatitis C treatment with Sofosbuvir/Ledipasvir in HCV/HIV Coinfected patients treated with Tenofovir and a boosted protease inhibitor: an observational prospective study |
| title_fullStr | Glomerular filtration rate change during chronic hepatitis C treatment with Sofosbuvir/Ledipasvir in HCV/HIV Coinfected patients treated with Tenofovir and a boosted protease inhibitor: an observational prospective study |
| title_full_unstemmed | Glomerular filtration rate change during chronic hepatitis C treatment with Sofosbuvir/Ledipasvir in HCV/HIV Coinfected patients treated with Tenofovir and a boosted protease inhibitor: an observational prospective study |
| title_short | Glomerular filtration rate change during chronic hepatitis C treatment with Sofosbuvir/Ledipasvir in HCV/HIV Coinfected patients treated with Tenofovir and a boosted protease inhibitor: an observational prospective study |
| title_sort | glomerular filtration rate change during chronic hepatitis c treatment with sofosbuvir ledipasvir in hcv hiv coinfected patients treated with tenofovir and a boosted protease inhibitor an observational prospective study |
| topic | Co-infection HIV/HCV HCV treatment Sofosbuvir/ledipasvir Renal toxicity Tenofovir Protease inhibitor |
| url | http://link.springer.com/article/10.1186/s12879-018-3278-3 |
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