Effective HCV Treatment Decreases Chronic Kidney Disease Incidence
Researchers examined the association of HCV infection with the incidence of CKD by analyzing a cohort of 56,448 HCV-infected patients.
Individuals infected with hepatitis C virus (HCV) are at greater risk of developing chronic kidney disease (CKD), membranoproliferative glomerulonephritis (MPGN), and cryoglobulinemia, and even minimally effective treatment of HCV infection can prevent the development of CKD, according to a new study.
Park et al. assessed the risk of CKD in HCV-infected patients and the incidence reduction of CKD after receipt of HCV treatment. They also evaluated the risk of MPGN and cryoglobulinemia in chronic HCV patients.
Using several databases, the researchers examined the association of HCV infection with the incidence of CKD by analyzing a cohort of 56,448 HCV-infected patients who were matched (1:3) with 169,344 non-HCV patients.
They found that, of 55,818 HCV patients, 6.6% (n=3666) received interferon-based dual therapy, 6.3% (n=3534) received interferon-based triple therapy, and 8.3% (n=4628) received all-oral direct-acting antiviral agents (DAA). In contrast, 79% of patients did not receive any HCV treatment.
The researchers used Cox proportional hazards models to compare the risk of developing CKD in HCV patients, as compared with non-HCV patients, and treated patients compared to non-treated patients. In a multivariate time-varying Cox regression model, compared to non-HCV patients, infected patients had a 27% increased risk of CKD (HR: 1.27; 95% CI: 1.18–1.37).
Among HCV patients, individuals who received the minimally effective HCV treatment for dual, triple, or all-oral therapy had a 30% decreased risk of developing CKD (HR,0.70; 95% CI,0.55–0.88). Moreover, compared to non-HCV patients, infected patients experienced a twofold higher risk of MPGN (HR: 2.23; 95% CI: 1.84–2.71) and an almost 17-fold higher risk of cryoglobulinemia (HR: 16.91; 95% CI: 12.00–23.81).
The researchers concluded that individuals infected with HCV infection are at greater risk of developing several conditions, including CKD, but receiving appropriate treatment could prevent this from occurring. However, they cautioned that the effectiveness of treatment was not significant for all-oral therapy.
Park, H, Chen, C, Wang, W, Henry, L, Cook, R. L, Nelson, DR. Chronic Hepatitis C increases the risk of chronic kidney disease (CKD) while effective HCV treatment decreases the incidence of CKD [published online September 5, 2017]. Hepatology. doi:10.1002/hep.29505