Evolution of renal function under direct-acting antivirals treatment for chronic hepatitis C: A real-world experience

Ming Chao Tsai, Chun Yen Lin, Chao Hung Hung, Sheng Nan Lu, Shui Yi Tung, Rong Nan Chien, Chih Lang Lin, Jing Houng Wang, Chen Chien-Hung, Kuo Chin Chang, Tsung Hui Hu*, I. Shyan Sheen

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

19 Scopus citations


Renal toxicity of direct-acting antivirals (DAAs) in chronic hepatitis C (CHC) patients has not been well-characterized. The aim of this study was to assess renal safety of DAAs in an Asian CHC patient cohort. Data from CHC patients (n = 1536) treated with DAAs were used in this retrospective study. Serial estimated glomerular filtration rate (eGFR) at pretreatment (1-year prior to treatment), baseline, end of treatment (EOT), and 12 weeks after treatment (SVR12) was evaluated. While a significant decrease in eGFR from baseline to EOT (84.8 → 81.8 mL/min/1.73 m2, P <.001) was observed; subsequently, a slight rise at SVR12 (84.3 mL/min/1.73 m2) was also evident. Changes in eGFR after DAA treatment were similar to those seen in PrOD, DCV/ASV and GZP/EBV regimens, except in the SOF-based regimen wherein eGFR remained unchanged from EOT to SVR12, especially in liver transplant recipients. Multivariate analysis revealed that age >65 years (OR = 1.862, P =.011), baseline eGFR ≥ 60 mL/min/1.73 m2 (OR = 2.684, P =.023), and liver transplant (OR = 3.894, P =.001) were independent risk factors for deteriorating renal function. In conclusion, DAA treatment led to a significant decline in eGFR at EOT but was followed by a slight rise at 12 weeks after treatment. A similar trend was observed with PrOD, DCV/ASV and GZP/EBV, but not in SOF-based regimens. As age >65 years, baseline eGFR ≥ 60 mL/min/1.73 m2 and liver transplantation are significant risk factors for deterioration in renal function, we strongly advice close monitoring of renal function in these populations.

Original languageEnglish
Pages (from-to)1404-1412
Number of pages9
JournalJournal of Viral Hepatitis
Issue number12
StatePublished - 01 12 2019

Bibliographical note

Publisher Copyright:
© 2019 John Wiley & Sons Ltd


  • direct-acting antivirals
  • estimated glomerular filtration rate
  • renal function


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