Direct-acting antiviral agent efficacy and safety in renal transplant recipients with chronic hepatitis C virus infection

Abstract

Background:The efficacy and safety of direct-acting antivirals (DAAs) for treating hepatitis C virus (HCV)-infected renal transplant recipients (RTRs) has not been determined.Methods:We searched PubMed, Embase, and the Cochrane Central Register of Controlled Trials and assessed the quality of eligible studies using the Joanna Briggs Institute scale. DAA efficacy and safety were assessed using standard mean difference (SMD) with 95% confidence intervals (95%CIs).Results:Six studies (360 RTRs) were included. Two hundred thirty six RTRs (98.3%) achieved sustained virological response within 12 weeks; HCV infection was cleared in 239 RTRs after 24-week treatment. Liver function differed significantly pre- and posttreatment (alanine aminotransferase, SMD: 0.96, 95%CIs: 0.65, 1.26; aspartate aminotransferase, SMD: 0.89, 95%CIs: 0.60, 1.18); allograft function pre- and posttreatment was not statistically different (serum creatinine, SMD: −0.13, 95%CIs: −0.38, 0.12; estimated glomerular filtration rate, SMD: 0.20, 95%CIs: −0.11, 0.51). General symptoms (fatigue nausea dizziness or headache) were the most common adverse events (AEs) (39.3%). Severe AEs, that is, anemia, portal vein thrombosis, and streptococcus bacteraemia and pneumonia, were present in 1.1%, 0.6%, and 1.1% of RTRs, respectively.Conclusion:Our findings suggest that DAAs are highly efficacious and safe for treating HCV-infected RTRs and without significant AE.

Effectiveness and safety of sofosbuvir‐based therapy against chronic hepatitis C infection after successful kidney transplantation

“…To the best of our knowledge, the present study recruited the largest (n = 40) homogenous group (ie, Caucasians) of patients treated in one center according to the same SOF‐based therapeutic scheme. Most previously published real‐life observations—collected in a meta‐analysis by Chen et al and a review by Chute et al—were multicenter studies that include ethnically diverse patients. However, ethnicity can affect the effectiveness of therapy .…”

Renal safety after one year of sofosbuvir‐based therapy for chronic hepatitis C: A Brazilian “real‐life” study

“…Studies designed to evaluate renal function after DAA therapy are lacking, especially “real life” studies with large population samples. Among these, the majority did not report a specific effect on renal function when DAA therapeutic schemes were used . A recent study of Sho et al.…”

“…Among these, the majority did not report a specific effect on renal function when DAA therapeutic schemes were used. 9,20,23,24 A recent study of Sho et al…”

Direct-Acting Antiviral Prophylaxis in Kidney Transplantation From Hepatitis C Virus–Infected Donors to Noninfected Recipients

“…However, the landscape of HCV changed in 2013 with the introduction of direct-acting antiviral (DAAs) with high cure rates even in KT. (13–17) In 2015, the once daily fixed-dose combination of the NS3/4A protease inhibitor grazoprevir (GZR) and the NS5A inhibitor elbasvir (EBR) was approved for use in individuals with impaired renal function and HCV genotype 1a infection. (18) For genotype 2 and 3 infection, the NS5B inihibitor sofosbuvir (SOF) is highly active (19).…”