Evaluation of renal function changes during sofosburvir and daclatasvir (+/- ribavirin) treatment in chronic HCV monoinfected patients compared to HCV/HIV co-infected patients / Naeema Mohamed Ahmed Gad ; Supervised Mohammad Salah Abdelbary , Shereen Abdalem Mohamed , Engy Mohamed Elkhateeb

Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Tropical Medicine

Background: Hepatitis C virus (HCV) infection among people living with human immunodeficiency virus (PLHI) is a growing worldwide health burden. Sofosbuvir is approved for HCV patients.The nephrotoxicity of SOF on HCV mono-infected and HCV/HIV patients receiving antiretroviral therapy (ART) remains controversial. Aim: to evaluatethe serial changes of renal indices during sofosbuvir (SOF) and daclatasvir (DCV) therapy in HCV mono-infected and HCV/HIV patients with normal to mildly impaired kidney functions. Patients and methods: A prospective study including 159 HCV mono-infected and 124 HCV/HIV patients (47 were ART-naïve and 77 were TDF-based cART) who presented with a baseline eGFR {u2265}60 ml/min/1.73m² and were treated with SOF/DCV for 12 weeks.The eGFR was calculated for each time of evaluation using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula.Results: HCV patients had a progressive eGFR decline compared to HCV/HIV patients who were ART-naive and those receiving TDF-based cART during and after discontinuing SOF/DAC treatment (95.5, 108.7,109.2 ml/min/1.73m² at baseline vs. 93.4, 113.8, 106.4 ml/min/1.73m² at EOT vs. 92.91, 113.8, 111.9 ml/min/1.73m² at SVR12, respectively). However, the rate of eGFR stage improvement was more pronounced in HCV mono-infected compared to HCV/HIV patients who were ART-naive and those receiving TDF-based ART at EOT and SVR12 (13.8% vs. 8.5% and 6.5% at EOTand 14.5% vs. 12.7% and 10.4% at SVR12, respectively).Multivariable regression analysis showed that baseline variables were not independent predictors of eGFR stage worsening either at EOT or SVR12

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