Renal Safety Profile of Triple DAA Therapy in HIV/HCV Coinfection Examined

renal function test
renal function test
A study evaluated the effects of HCV treatment with direct-acting antivirals on renal function in patients with HIV/HCV coinfection.

Ombitasvir/paritaprevir/ritonavir plus dasabuvir has a good renal safety profile in patients coinfected with HIV/hepatitis C, according to results published in PLoS ONE.

The study included 144 patients coinfected with HIV and hepatitis C genotype 1 who were treated with ombitasvir/paritaprevir/ritonavir plus dasabuvir.

At end of treatment, 41.7% of patients had ≥5% reduction in estimated glomerular filtration fate (eGFR). Of those patients, 65.0% still had this reduction after 12 weeks of follow-up. The median decline of eGFR was 2 mL/minute. Although this is statistically significant, the researchers wrote that it has “doubtful clinical significance.”

Longer duration of hepatitis C infection (cutoff, 12.9 years), lower hepatitis C-RNA viral load (cutoff, 1,970,160 IU/mL), and lower platelet count (cutoff, 167,000 ×106/L) were significantly associated with eGFR decline at logistic analysis (odds ratio [OR], 2.9 [95% CI, 1.0-8.8; P =.05]; OR, 3.5 [95% CI, 1.2-10.4; P =.02]; OR, 2.8 [95% CI, 1.1-6.8; P =.03], respectively).

The researchers then repeated the analysis with a mixed model. This found that a higher eGFR decline was more likely in patients concomitantly treated with tenofovir (P =.0001), ribavirin (P =.0001), or integrase inhibitors (P <.0001), with longer duration of HIV (P =.0002) and hepatitis C infection (P =.035), lower baseline hepatitis C RNA (P <.0001), previous hepatitis C treatment (P <.0001), and older age (P <.0001).

The researchers noted that the role of age, concomitant therapies, and duration of HIV/HCV infection needs to be further investigated.

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Taramasso L, Di Biagio A, Bovis F, et al. Trend of estimated glomerular filtration rate during ombistasvir/paritaprevir/ritonavir plus dasabuvir ± ribavirin in HIV/HCV co-infected patients. PLoS ONE. 13(2):e0192927.