New treatment for hepatitis C in chronic kidney disease, dialysis, and transplant

Fabrizio Fabrizi, Paul Martin, Piergiorgio Messa

Research output: Contribution to journalReview article

22 Citations (Scopus)

Abstract

The evidence that chronic hepatitis C plays a detrimental role in survival among patients on maintenance dialysis or renal transplant recipients promotes the antiviral treatment of hepatitis C virus (HCV) among chronic kidney disease patients. Also, it seems that HCV infection is associated with an increased risk of developing chronic kidney disease in the adult general population. Interferon-based regimens have provided limited efficacy and safety among chronic kidney disease patients, whereas the advent of the new direct-acting antivirals for the treatment of hepatitis C (launched over the past 5 years) has given the opportunity to reach sustained virologic response rates of 90% for many patient groups. Unfortunately, poor information exists regarding the antiviral treatment of hepatitis C in the chronic kidney disease population. The first published data on the treatment of hepatitis C among patients with chronic kidney disease (stage 4-5) and HCV genotype 1 regard the grazoprevir (NS3/4A protease inhibitor) and elbasvir (NS5A inhibitor) combination; excellent efficacy (sustained viral response, 94.3%; 115/122) and safety have been achieved. Preliminary evidence on the combined treatment of sofosbuvir (NS5B inhibitor) and simeprevir (NS3/4A inhibitor) has given a viral response of 89%, but the size of the study group (n = 38 patients with end-stage renal disease) was small. Some phase 2 and 3 clinical trials based on other antiviral combinations (3D regimen, sofosbuvir/ledipasvir, or other sofosbuvir-containing approaches) are ongoing. Thus, the antiviral regimens based on direct-acting antivirals promise to play a pivotal role in the eradication of hepatitis C among kidney disease patients. Direct-acting antivirals are very expensive; in an era of cost containment this is a crucial point either in developed and developing countries. Adverse drug reactions resulting from concomitantly administered medications are another ongoing concern for patients undergoing HCV treatment, particularly for chronic kidney disease patients who have a heavy burden of comorbidities.

Original languageEnglish (US)
Pages (from-to)988-994
Number of pages7
JournalKidney International
Volume89
Issue number5
DOIs
StatePublished - May 1 2016

Fingerprint

Hepatitis C
Chronic Renal Insufficiency
Dialysis
Antiviral Agents
Transplants
Hepacivirus
Therapeutics
Safety
Phase III Clinical Trials
Cost Control
Kidney Diseases
Chronic Hepatitis C
Virus Diseases
Protease Inhibitors
Drug-Related Side Effects and Adverse Reactions
Developed Countries
Interferons
Population
Developing Countries
Chronic Kidney Failure

Keywords

  • chronic kidney disease
  • dialysis
  • direct-acting antivirals
  • hepatitis C
  • peg-interferon
  • renal transplant
  • ribavirin

ASJC Scopus subject areas

  • Medicine(all)
  • Nephrology

Cite this

New treatment for hepatitis C in chronic kidney disease, dialysis, and transplant. / Fabrizi, Fabrizio; Martin, Paul; Messa, Piergiorgio.

In: Kidney International, Vol. 89, No. 5, 01.05.2016, p. 988-994.

Research output: Contribution to journalReview article

Fabrizi, Fabrizio ; Martin, Paul ; Messa, Piergiorgio. / New treatment for hepatitis C in chronic kidney disease, dialysis, and transplant. In: Kidney International. 2016 ; Vol. 89, No. 5. pp. 988-994.
@article{9a6364af6c3d4d3bb860c03f932b0c61,
title = "New treatment for hepatitis C in chronic kidney disease, dialysis, and transplant",
abstract = "The evidence that chronic hepatitis C plays a detrimental role in survival among patients on maintenance dialysis or renal transplant recipients promotes the antiviral treatment of hepatitis C virus (HCV) among chronic kidney disease patients. Also, it seems that HCV infection is associated with an increased risk of developing chronic kidney disease in the adult general population. Interferon-based regimens have provided limited efficacy and safety among chronic kidney disease patients, whereas the advent of the new direct-acting antivirals for the treatment of hepatitis C (launched over the past 5 years) has given the opportunity to reach sustained virologic response rates of 90{\%} for many patient groups. Unfortunately, poor information exists regarding the antiviral treatment of hepatitis C in the chronic kidney disease population. The first published data on the treatment of hepatitis C among patients with chronic kidney disease (stage 4-5) and HCV genotype 1 regard the grazoprevir (NS3/4A protease inhibitor) and elbasvir (NS5A inhibitor) combination; excellent efficacy (sustained viral response, 94.3{\%}; 115/122) and safety have been achieved. Preliminary evidence on the combined treatment of sofosbuvir (NS5B inhibitor) and simeprevir (NS3/4A inhibitor) has given a viral response of 89{\%}, but the size of the study group (n = 38 patients with end-stage renal disease) was small. Some phase 2 and 3 clinical trials based on other antiviral combinations (3D regimen, sofosbuvir/ledipasvir, or other sofosbuvir-containing approaches) are ongoing. Thus, the antiviral regimens based on direct-acting antivirals promise to play a pivotal role in the eradication of hepatitis C among kidney disease patients. Direct-acting antivirals are very expensive; in an era of cost containment this is a crucial point either in developed and developing countries. Adverse drug reactions resulting from concomitantly administered medications are another ongoing concern for patients undergoing HCV treatment, particularly for chronic kidney disease patients who have a heavy burden of comorbidities.",
keywords = "chronic kidney disease, dialysis, direct-acting antivirals, hepatitis C, peg-interferon, renal transplant, ribavirin",
author = "Fabrizio Fabrizi and Paul Martin and Piergiorgio Messa",
year = "2016",
month = "5",
day = "1",
doi = "10.1016/j.kint.2016.01.011",
language = "English (US)",
volume = "89",
pages = "988--994",
journal = "Kidney International",
issn = "0085-2538",
publisher = "Nature Publishing Group",
number = "5",

}

TY - JOUR

T1 - New treatment for hepatitis C in chronic kidney disease, dialysis, and transplant

AU - Fabrizi, Fabrizio

AU - Martin, Paul

AU - Messa, Piergiorgio

PY - 2016/5/1

Y1 - 2016/5/1

N2 - The evidence that chronic hepatitis C plays a detrimental role in survival among patients on maintenance dialysis or renal transplant recipients promotes the antiviral treatment of hepatitis C virus (HCV) among chronic kidney disease patients. Also, it seems that HCV infection is associated with an increased risk of developing chronic kidney disease in the adult general population. Interferon-based regimens have provided limited efficacy and safety among chronic kidney disease patients, whereas the advent of the new direct-acting antivirals for the treatment of hepatitis C (launched over the past 5 years) has given the opportunity to reach sustained virologic response rates of 90% for many patient groups. Unfortunately, poor information exists regarding the antiviral treatment of hepatitis C in the chronic kidney disease population. The first published data on the treatment of hepatitis C among patients with chronic kidney disease (stage 4-5) and HCV genotype 1 regard the grazoprevir (NS3/4A protease inhibitor) and elbasvir (NS5A inhibitor) combination; excellent efficacy (sustained viral response, 94.3%; 115/122) and safety have been achieved. Preliminary evidence on the combined treatment of sofosbuvir (NS5B inhibitor) and simeprevir (NS3/4A inhibitor) has given a viral response of 89%, but the size of the study group (n = 38 patients with end-stage renal disease) was small. Some phase 2 and 3 clinical trials based on other antiviral combinations (3D regimen, sofosbuvir/ledipasvir, or other sofosbuvir-containing approaches) are ongoing. Thus, the antiviral regimens based on direct-acting antivirals promise to play a pivotal role in the eradication of hepatitis C among kidney disease patients. Direct-acting antivirals are very expensive; in an era of cost containment this is a crucial point either in developed and developing countries. Adverse drug reactions resulting from concomitantly administered medications are another ongoing concern for patients undergoing HCV treatment, particularly for chronic kidney disease patients who have a heavy burden of comorbidities.

AB - The evidence that chronic hepatitis C plays a detrimental role in survival among patients on maintenance dialysis or renal transplant recipients promotes the antiviral treatment of hepatitis C virus (HCV) among chronic kidney disease patients. Also, it seems that HCV infection is associated with an increased risk of developing chronic kidney disease in the adult general population. Interferon-based regimens have provided limited efficacy and safety among chronic kidney disease patients, whereas the advent of the new direct-acting antivirals for the treatment of hepatitis C (launched over the past 5 years) has given the opportunity to reach sustained virologic response rates of 90% for many patient groups. Unfortunately, poor information exists regarding the antiviral treatment of hepatitis C in the chronic kidney disease population. The first published data on the treatment of hepatitis C among patients with chronic kidney disease (stage 4-5) and HCV genotype 1 regard the grazoprevir (NS3/4A protease inhibitor) and elbasvir (NS5A inhibitor) combination; excellent efficacy (sustained viral response, 94.3%; 115/122) and safety have been achieved. Preliminary evidence on the combined treatment of sofosbuvir (NS5B inhibitor) and simeprevir (NS3/4A inhibitor) has given a viral response of 89%, but the size of the study group (n = 38 patients with end-stage renal disease) was small. Some phase 2 and 3 clinical trials based on other antiviral combinations (3D regimen, sofosbuvir/ledipasvir, or other sofosbuvir-containing approaches) are ongoing. Thus, the antiviral regimens based on direct-acting antivirals promise to play a pivotal role in the eradication of hepatitis C among kidney disease patients. Direct-acting antivirals are very expensive; in an era of cost containment this is a crucial point either in developed and developing countries. Adverse drug reactions resulting from concomitantly administered medications are another ongoing concern for patients undergoing HCV treatment, particularly for chronic kidney disease patients who have a heavy burden of comorbidities.

KW - chronic kidney disease

KW - dialysis

KW - direct-acting antivirals

KW - hepatitis C

KW - peg-interferon

KW - renal transplant

KW - ribavirin

UR - http://www.scopus.com/inward/record.url?scp=84964658630&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84964658630&partnerID=8YFLogxK

U2 - 10.1016/j.kint.2016.01.011

DO - 10.1016/j.kint.2016.01.011

M3 - Review article

C2 - 27083277

AN - SCOPUS:84964658630

VL - 89

SP - 988

EP - 994

JO - Kidney International

JF - Kidney International

SN - 0085-2538

IS - 5

ER -