Viruses and The Kidney
Multicenter Study to Transplant Hepatitis C-Infected Kidneys (MYTHIC)
This multi-center trial included 30 patients who received kidney transplantations from deceased HCV-positive donors with early initiation of an 8-week regimen of glecaprevir and pibrentasvir. All 30 had sustained virologic response at 12 weeks post treatment, and no severe adverse events were deemed related to study.
Multicenter Study to Transplant Hepatitis C-Infected Kidneys (MYTHIC)
This multi-center trial included 30 patients who received kidney transplantations from deceased HCV-positive donors with early initiation of an 8-week regimen of glecaprevir and pibrentasvir. All 30 had sustained virologic response at 12 weeks post treatment, and no severe adverse events were deemed related to study.
Low Complement C4 Predicts Improvement of Kidney Function After Direct-Acting Antiviral Therapy for Hepatitis C Virus
Direct-acting antivirals have revolutionized the treatment for patients infected with hepatitis C. We conducted a trial of 10 patients who received ledipasvir and sofosbuvir to treat hepatitis C in order to examine their renal effects. We also conducted a retrospective cohort study of patients in our health care system who had baseline complement component 4 (C4) measured before DAAs for HCV in order to examine renal effects. We found that low baseline C4 may be a marker of kidney dysfunction that improve with DAA therapy.
Preemptive Treatment With Elbasvir and Grazoprevir for Hepatitis C–Viremic Donor to Uninfected Recipient Kidney Transplantation
This was pilot trial to transplant kidneys from HCV-infected donors into HCV-naive recipients with preemptive use of elbasvir and grazoprevir for 12 weeks. Eight patients enrolled in and completed the study, and none had detectable viremia beyond 2 weeks post transplantation and all had sustained virologic response at 12 weeks post treatment.
Direct-acting antiviral therapy slows kidney function decline in patients with Hepatitis C virus infection and chronic kidney disease
Predictors of eGFR Predictors of eGFR improvement included having CKD at baseline and being non-diabetic. Events of acute kidney injury were rare, occurring in 29 patients, and unrelated to antiviral therapy in 76% of cases. Thus, DAA therapy for HCVs infection may slow CKD progression.
