Journal d'hépatologie et des troubles gastro-intestinaux
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Effect of Direct Acting Antiviral Drugs in Hepatitis C Virus infected Egyptian Patients with Nephropathy: A Single Center Study

Alaa Sabry, Ahmed Elsaeed, Shahera Eletreby, Fatma El-Husseini, Nagy Sayed Ahmed

Objectives: Determination of the sustained virologic response in chronic HCV infected patients with HCV related nephropathy receiving direct acting antiviral drugs and assessment of the immunological, clinical and renal responses to DAAs in this group of patients.

Methods: This prospective observational study was carried out over a period of two years and included 34 patients diagnosed with HCV nephropathy for whom virological, immunological, clinical and renal responses were assessed pre and 12 weeks post treatment who were planned to be treated with Direct Acting Antivirals (DAAs) (in the form of combination of OBV-PTV/r with RBV, combination of SOF/SIM, or combination of SOF/DCV with or without RBV according to the availability).

Results: Thirty four HCV nephropathy patients were observed while receiving DAAs and for 12 weeks after. Renal biopsy was done in thirty patients while four refused. The mean age of patients was 53.1 ± 10.1 years and 55.9% of them were males. Membranoproliferative lesion was detected in 83% of biopsied cases. Sustained virological response 12 weeks after treatment detected in 97%. The median eGFR and proteinuria were improved after treatment, However, Partial and complete improvement of eGFR and proteinuria was detected in 57% and 44% of patients, respectively. Clinical response of other extra renal manifestations and immunological response either complete or partial were detected in 59% and 47% respectively.

Conclusion: The use of DAAs was highly effective and tolerable in Egyptian patients infected with HCV and has-associated Nephropathy, with high virological response rates in these patients. This was associated with amelioration of renal disease in half of the nephropathic patients. The occurrence of AKI with DAA regimens used in the study was independent of other AKI precipitating factors, transient and reversible after the end of treatment denoting renal safety of these drugs in patients with normal renal function.