Impact of hepatitis C virus and direct acting antivirals on kidney recipients: a retrospective study

Transpl Int. 2019 May;32(5):493-501. doi: 10.1111/tri.13393. Epub 2019 Jan 11.

Abstract

Hepatitis C virus (HCV) in kidney transplanted patients (KTx-p) carries a high risk for a worse outcome. This retrospective study evaluates the impact of HCV and of the new direct acting antivirals (DAAs) on patient and graft outcomes in KTx patients. Forty (6.5%) of the 616 KTx-p, who received a kidney transplantation (KTx) in our Centre had antibodies against HCV: 13 were positive for HCV RNA and received DAAs (Group A); 11 were HCV RNA positive and did not receive any treatment (Group B; n = 11); 16 were negative for HCV RNA (Group C). All Group A patients had HCV RNA negativity after 12 weeks of treatment, and 12 (92.30%) achieved a sustained virological response (SVR). Only two patients, who had proteinuria greater than 500 mg/day showed a worsening of proteinuria after antiviral therapy in Group A. Liver enzyme elevation and death were significantly more frequent in Group B than other groups. Our results support the notion that active HCV infection negatively affects kidney recipients and that DAA have a high safety and efficacy profile after KTx with no significant negative effect on allograft function, particularly in well-functioning renal grafts.

Keywords: direct acting antivirals; graft outcome; hepatitis-C; kidney transplantation.

MeSH terms

  • Adult
  • Antiviral Agents / therapeutic use*
  • Disease Progression
  • Drug Therapy, Combination
  • Female
  • Hepacivirus
  • Hepatitis C, Chronic / drug therapy*
  • Humans
  • Kidney / physiology
  • Kidney Failure, Chronic / complications
  • Kidney Failure, Chronic / surgery*
  • Kidney Failure, Chronic / virology
  • Kidney Transplantation*
  • Liver / enzymology
  • Male
  • Middle Aged
  • Patient Safety
  • Proteinuria
  • Retrospective Studies
  • Simeprevir / therapeutic use*
  • Sofosbuvir / therapeutic use*
  • Sustained Virologic Response

Substances

  • Antiviral Agents
  • Simeprevir
  • Sofosbuvir