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4/2023
vol. 9
abstract:
Original paper
Real-world effectiveness of genotype-specific and pangenotypic direct-acting antivirals in HCV-infected patients with renal failure
Dorota Zarębska-Michaluk
3
,
Justyna Janocha-Litwin
5
,
Magdalena Tudrujek-Zdunek
10
,
Anna Parfieniuk-Kowerda
14
,
- Department of Transplantation Medicine, Nephrology, and Internal Diseases, Medical University of Warsaw, Warsaw, Poland
- Collegium Medicum, Jan Kochanowski University, Kielce, Poland
- Department of Infectious Diseases and Allergology, Jan Kochanowski University, Kielce, Poland
- Pomeranian Center of Infectious Diseases, Medical University Gdańsk, Gdańsk, Poland
- Department of Infectious Diseases and Hepatology, Wrocław Medical University, Wrocław, Poland
- Outpatient Clinic, Hospital for Infectious Diseases in Warsaw, Warsaw, Poland
- Department of Infectious and Tropical Diseases, Jagiellonian University, Kraków, Poland
- Department of Infectious Diseases and Hepatology, Faculty of Medicine, Nicolaus Copernicus University, Bydgoszcz, Poland
- Clinical Department of Infectious Diseases, Medical University of Silesia, Chorzów, Poland
- Department of Infectious Diseases, Medical University of Lublin, Lublin, Poland
- Department of Basic Medical Sciences, School of Public Health in Bytom, Medical University of Silesia, Katowice, Poland
- Department of Internal Medicine and Hepatology, The National Institute of Medicine of the Ministry of Interior and Administration,
Warsaw, Poland
- MED-FIX Medical Center, Wrocław, Poland
- Department of Infectious Diseases and Hepatology, Medical University of Białystok, Białystok, Poland
- Outpatients Hepatology Department, NZOZ GEMINI, Żychlin, Poland
- Department of Infectious Diseases, Hepatology, and Liver Transplantation, Pomeranian Medical University, Szczecin, Poland
Clin Exp HEPATOL 2023; 9, 4: 320-334
Online publish date: 2023/12/15
PlumX metrics:
Aim of the study:
The aim is to summarize the effectiveness and safety of genotype-specific and pangenotypic hepatitis C virus (HCV) treatments in patients with renal failure.
Material and methods:
In the EpiTer-2 database, which includes data from 22 hepatology centers in Poland, 593 patients with HCV infection and kidney failure were identified. According to KDIGO 2022, they fulfilled the criteria of chronic kidney disease. Patients were divided into two groups: treated with genotype-specific regimens (n = 428) and pangenotypic options (n = 165), in relation to the stage of kidney disease determined using the glomerular filtration rate (GFR) (Cockcroft and Gault equation). Two separate groups were created for hemodialyzed patients (n = 134) and patients after kidney transplantation (n = 89).
Results:
In a total of 593 patients, 78.7% were treatment-naïve and 23.9% had liver cirrhosis, in 27.5% of cases decompensated. In both groups, the dominant genotype was GT1b. Among patients treated with genotype-specific regimens, LDV/SOF ± RBV, OBV/PTV/r + DSV ± RBV, and GZR/EBR ± RBV treatments were given to 31.5%, 31.5%, and 34.8% of patients respectively. In pangenotypic regimens, GLE/PIB was chosen in 50.3%. Ninety-six percent and 98.8% of patients in the genotype-specific regimen and 88.5% and 94.8% in the pangenotypic regimen achieved a sustained virologic response at 12 weeks (SVR12) in the intention-to-treat and per protocol population respectively. Liver cirrhosis was identified as a risk factor for virological failure. During the study, 14 patients died, 7 in each of the two groups, none related to the antiviral treatment.
Conclusions:
Both types of treatment regimens are equally effective and safe in patients with renal failure. The stage of renal failure or transplant does not influence the antiviral response.
keywords:
chronic hepatitis C, renal failure, sustained virologic response, direct-acting antivirals, pangenotypic
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