Journal of Clinical and Translational Hepatology

Journal of Clinical and Translational Hepatology

Saturday, 04 / 20 / 2019

Articles

Effect of Hepatitis C Treatment on Renal Function in Liver Transplant Patients

ORIGINAL ARTICLE OPEN ACCESS
Effect of Hepatitis C Treatment on Renal Function in Liver Transplant Patients
Mohamed Shoreibah1, John Romano*,2, Omar T. Sims34,5, Yuqi Guo6, DeAnn Jones7, Krishna Venkata2, Vishnu Kommineni2, Jordan Orr8, Paul Fitzmorris1 and Omar I. Massoud1
Journal of Clinical and Translational Hepatology 2018;6(4):391-395DOI: 10.14218/JCTH.2018.00026
Received: April 10, 2018Accepted: June 23, 2018Published online: July 11, 2018
Author information
1Division of Gastroenterology & Hepatology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
2Department of Internal Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
3Department of Social Work, College of Arts and Sciences, University of Alabama at Birmingham, Birmingham, AL, USA
4Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
5Center for AIDS Research, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
6School of Social Work, University of Alabama, Tuscaloosa, AL, USA
7Department of Pharmacology, University of Alabama at Birmingham, Birmingham, AL, USA
8Division of Gastroenterology and Hepatology, Department of Medicine, Vanderbilt University, Nashville, TN, USA
*Correspondence to: John Romano, Department of Internal Medicine, School of Medicine, University of Alabama at Birmingham, BDB 327, 1808 7th Ave South, Birmingham, AL 35233, USA. Tel: +1-3156574626, E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
Abstract
Background and Aims: Hepatitis C Virus (HCV) is uniformly recurrent after liver transplant (LT) and recurrence is associated with an increased risk of mortality. Immunosuppressive medications increase the risk of chronic kidney disease, and the presence of chronic kidney disease presents a challenge for HCV treatment in LT recipients. The aim of this study was to assess changes in glomerular filtration rates (GFRs) of LT recipients receiving HCV treatment.

Methods: This is a retrospective study of LT patients who received HCV treatment between 2015 and 2016 (n = 60). The outcomes of interest were differences in serum creatinine levels and in GFR, measured at treatment initiation and at 24 weeks after treatment. The average age of the patients was 59 years-old, and 17% were cirrhotic and 67% were treatment-experienced. All patients received sofosbuvir/ledipasvir without ribavirin.

Results: All patients achieved sustained virologic response at 12 weeks after treatment (SVR12). At baseline, 55% of patients had GFR <60 mL/min per 1.73 m2. Among those patients, GFR did not change in 18%, 33% had improved GFR, and 48% had worsened GFR. Up to 45% of the patients had a GFR >60 mL/min per 1.73 m2. Among those patients, GFR did not change in 81%, and 19% had worsened GFR. In the entire cohort, 65% of patients had improved or stable GFR and 35% had worsened GFR. The average change in serum creatinine between baseline and 24 weeks was 0.10 (p = 0.18).

Conclusions: This study showed improved or unchanged GFR in 65% and worsened GFR in 35% of LT recipients who achieved SVR12. Worsening of GFR was more frequently encountered in those with impaired renal function at baseline. Caution should be used when treating HCV in LT recipients, especially those with baseline status of renal impairment.

Keywords
Hepatitis C, Renal function, Direct-acting antivirals, Liver transplant, Treatment

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