A new study indicates that direct-acting antiviral therapy is safe and effective in patients with chronic kidney disease (CKD) and Hepatitis C virus (HCV) infection. The study, which appears in an upcoming issue of the Clinical Journal of the American Society of Nephrology (CJASN), also found that treatment may help improve some patients’ kidney function.
HCV infection—which often causes liver disease—is common in patients with CKD, and it increases their risk of progressing to kidney failure. Sofosbuvir is a potent direct-acting antiviral therapy against HCV, but concerns about potential kidney toxicity have been raised, particularly in patients with CKD.
Overall sustained virologic response (which is synonymous with cure of HCV infection) was 81%, and average kidney function while on the treatment was stable. Patients with more advanced CKD were more likely to be cured of HCV infection than those with mild CKD. In addition, patients with advanced CKD who were cured of HCV infection experienced an improvement in their kidney function following treatment. Sofosbuvir was reasonably well tolerated: adverse events were common (81%), but serious adverse events (17%) and treatment discontinuations (8%) were uncommon. Also, there was no detectable effect of the degree of CKD on the rate of adverse events.