Impact of Sofosbuvir-Based Direct-Acting Antivirals on Renal Function in Chronic Hepatitis C Patients With Impaired Renal Function: A Large Cohort Study From the Nationwide HCV Registry Program (TACR)

Chung Feng Huang, Kuo Chih Tseng, Pin Nan Cheng, Chao Hung Hung, Ching Chu Lo, Cheng Yuan Peng, Ming Jong Bair, Ming Lun Yeh, Chien Hung Chen, Pei Lun Lee, Chun Yen Lin, Hsing Tao Kuo, Chun Ting Chen, Chi Chieh Yang, Jee Fu Huang, Chi Ming Tai, Jui Ting Hu, Chih Lang Lin, Wei Wen Su, Wei Lun TsaiYi Hsiang Huang, Chien Yu Cheng, Chih Lin Lin, Chia Chi Wang, Sheng Shun Yang, Lein Ray Mo, Guei Ying Chen, Chun Chao Chang, Szu Jen Wang, Chia Sheng Huang, Tsai Yuan Hsieh, Chih Wen Lin, Tzong Hsi Lee, Lee Won Chong, Chien Wei Huang, Shiuh Nan Chang, Ming Chang Tsai, Shih Jer Hsu, Jia Horng Kao, Chun Jen Liu, Chen Hua Liu, Han Chieh Lin, Mei Hsuan Lee, Pei Chien Tsai, Chia Yen Dai, Wan Long Chuang, Chi Yi Chen, Ming Lung Yu

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)

Abstract

Background & Aims: Sofosbuvir is approved for chronic hepatitis C (CHC) patients with severe chronic kidney disease (CKD). The impact of sofosbuvir-based therapy on renal function augmentation on a real-world nationwide basis is elusive. Methods: The 12,995 CHC patients treated with sofosbuvir-based (n = 6802) or non–sofosbuvir-based (n = 6193) regimens were retrieved from the Taiwan nationwide real-world HCV Registry Program. Serial estimated glomerular filtration rate (eGFR) levels were measured at baseline, end of treatment (EOT), and end of follow-up (EOF) (3 months after EOT). Results: The eGFR decreased from baseline (91.4 mL/min/1.73 m2) to EOT (88.4 mL/min/1.73 m2; P <.001) and substantially recovered at EOF (88.8 mL/min/1.73 m2) but did not return to pretreatment levels (P <.001). Notably, a significant decrease in eGFR was observed only in patients with baseline eGFR ≥90 mL/min/1.73 m2 (from 112.9 to 106.4 mL/min/1.73 m2; P <.001). In contrast, eGFR increased progressively in patients whose baseline eGFR was <90 mL/min/1.73 m2 (from 70.0 to 71.5 mL/min/1.73 m2; P <.001), and this increase was generalized across different stages of CKD. The trend of eGFR amelioration was consistent irrespective of sofosbuvir usage. Multivariate adjusted analysis demonstrated that baseline eGFR >90 mL/min/1.73 m2 was the only factor independently associated with significant slope coefficient differences of eGFR (–1.98 mL/min/1.73 m2; 95% confidence interval, –2.24 to –1.72; P <.001). The use of sofosbuvir was not an independent factor associated with eGFR change. Conclusions: Both sofosbuvir and non–sofosbuvir-based regimens restored renal function in CHC patients with CKD, especially in those with significant renal function impairment.

Original languageEnglish
Pages (from-to)1151-1162.e6
JournalClinical Gastroenterology and Hepatology
Volume20
Issue number5
DOIs
Publication statusPublished - May 2022

Keywords

  • CKD
  • DAA
  • eGFR
  • Real World
  • Sofosbuvir

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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