Expert opinion on the management of renal manifestations of chronic HCV infection

Chronic HCV infection is a non-traditional (but modifiable) risk factor for chronic kidney disease and has been implicated in glomerular injury and nephrosclerotic disease. Three HCV direct-acting antiviral regimens are available for patients with severe kidney impairment: ombitasvir, paritaprevir w...

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Bibliographic Details
Published in:Antiviral therapy 2018, Vol.23 (Suppl 2), p.57-67
Main Authors: Fabrizi, Fabrizio, Negro, Francesco, Bondin, Mark, Cacoub, Patrice
Format: Article
Language:English
Subjects:
2-Naphthylamine
Amides
Aminoisobutyric Acids
Anilides - therapeutic use
Antiviral Agents - therapeutic use
Benzimidazoles - therapeutic use
Benzofurans - therapeutic use
Carbamates - therapeutic use
Cyclopropanes
Disease Management
Drug Therapy, Combination
Hepacivirus - drug effects
Hepacivirus - pathogenicity
Hepacivirus - physiology
Hepatitis C, Chronic - complications
Hepatitis C, Chronic - drug therapy
Hepatitis C, Chronic - physiopathology
Human health and pathology
Humans
Imidazoles - therapeutic use
Infectious diseases
Lactams, Macrocyclic
Leucine - analogs & derivatives
Life Sciences
Macrocyclic Compounds - therapeutic use
Practice Guidelines as Topic
Proline - analogs & derivatives
Pyrrolidines
Quinoxalines - therapeutic use
Renal Insufficiency, Chronic - complications
Renal Insufficiency, Chronic - drug therapy
Renal Insufficiency, Chronic - physiopathology
Risk Factors
Ritonavir - therapeutic use
Sulfonamides - therapeutic use
Uracil - analogs & derivatives
Uracil - therapeutic use
Urology and Nephrology
Valine
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Summary:Chronic HCV infection is a non-traditional (but modifiable) risk factor for chronic kidney disease and has been implicated in glomerular injury and nephrosclerotic disease. Three HCV direct-acting antiviral regimens are available for patients with severe kidney impairment: ombitasvir, paritaprevir with the pharmacokinetic enhancer ritonavir, and dasabuvir; glecaprevir plus pibrentasvir; and elbasvir plus grazoprevir. In patients with severe kidney impairment, sofosbuvir-free regimens are preferred because sofosbuvir accumulation has been associated with a progressive worsening of renal function. In this Review, we provide our expert opinion on the current HCV treatment paradigm and highlight the remaining issues that need to be overcome to improve the treatment of HCV in this population.
ISSN:1359-6535
2040-2058
2040-2058
DOI:10.3851/IMP3247