Hepatitis C

In HCV/HIV Coinfection, Treatment May Be Tied to Lower eGFR

The use of sofosbuvir/ledipasvir (SOF/LDV) with or without tenofovir (TDF) may be associated with a decreased estimated glomerular filtration rate (eGFR) in patients coinfected with hepatitis C virus (HCV) and human immunodeficiency virus (HIV).


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These findings arose from a study of 273 patients with HCV/HIV coinfection. The participants were placed in 1 of 3 categories based on their antiretroviral (ARV) treatment regimen:

 

  • Non-TDF (n = 145)
  • Non-boosted TDF (n = 78)
  • TDF + boosted protease inhibitor (n = 50)

 

Over the course of the study, a statistically significant decrease in eGFR was observed in all treatment groups. Although few differences were observed between groups with respect to the decrease in eGFR, this decrease was most evident in the unboosted TDF group (− 5.40 ml/min/1.73m2).

 

A greater decrease in eGFR was also observed in patients who received 24 weeks of treatment and in patients with cirrhosis.

 

“We observed a significant decrease in eGFR during treatment in all study groups, that was small and reversible after SOF/LDV discontinuation,” the researchers concluded. “TDF was not associated with an increase in renal toxicity.”

 

—Christina Vogt

 

Reference:

São Pedro Soeiro CA, Melo Gonçalves CA, Correia Marques MS, et al. Glomerular filtration rate change during chronic hepatitis C treatment with Sofosbuvir/Ledipasvir in HCV/HIV Coinfected patients treated with Tenofovir and a boosted protease inhibitor: an observational prospective study [Published online August 3, 2018]. BMC Infect Dis. https://doi.org/10.1186/s12879-018-3278-3