HCV treatment easy on kidney in infected patients with CKD

Both sofosbuvir and nonsofosbuvir-based regimens work to restore renal function in patients with chronic hepatitis C virus (HCV) infection and concomitant chronic kidney disease (CKD), particularly those with significant renal impairment, according to a study.

The study used data from the Taiwan nationwide real-world HCV Registry Program and included 12,995 CHC patients treated with either sofosbuvir- (n=6,802) or nonsofosbuvir-based (n=6,193) regimens. Researchers measured serial estimated glomerular filtration rate (eGFR) levels at baseline, end of treatment (EOT), and end of follow-up (EOF; 3 months after EOT).

In the entire cohort, the eGFR level dropped from 91.4 mL/min/1.73 m² at baseline to 88.4 mL/min/1.73 m² at EOT (p<0.001). At EOF, the level slightly increased at 88.8 mL/min/1.73 m² but did not return to pretreatment levels (p<0.001).

Of note, there was a marked reduction in eGFR seen only in patients with baseline levels ≥90 mL/min/1.73 m² (from 112.9 to 106.4 mL/min/1.73 m²; p<0.001). In contrast, eGFR rose progressively in patients with baseline eGFR <90 mL/min/1.73 m2 (from 70.0 to 71.5 mL/min/1.73 m²; p<0.001), with the increase generally observed across different stages of CKD. The trend of eGFR improvement was consistent irrespective of sofosbuvir usage.

On multivariate adjusted analysis, baseline eGFR >90 ml/min/1.73 m² emerged as the only factor associated with significant change in eGFR following treatment (–1.98 ml/min/1.73 m², 95 percent confidence interval, –2.24 to –1.72; p<0.001). Sofosbuvir usage had no influence on eGFR change.