Clin Mol Hepatol.  2020 Oct;26(4):554-561. 10.3350/cmh.2020.0058.

Use of glecaprevir/pibrentasvir in patients with chronic hepatitis C virus infection and severe renal impairment

Affiliations
  • 1Division of Nephrology, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China
  • 2Division of Gastroenterology and Hepatology, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China
  • 3Division of Gastroenterology, Department of Internal Medicine, Changhua Christian Hospital, Taiwan
  • 4Department of Medicine and Therapeutics, State Key Laboratory of Digestive Disease, Institute of Digestive Disease, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
  • 5Division of Gastroenterology, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
  • 6Department of Internal Medicine, National Taiwan University Hospital Yunlin Branch, Douliu, Taiwan
  • 7Liver Diseases Research Centre, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taipei, Taiwan
  • 8Department of Medicine, Queen Elizabeth Hospital, Hong Kong, China
  • 9Department of Medicine and Geriatrics, Tuen Mun Hospital, Hong Kong, China
  • 10Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
  • 11Department of Medicine and Geriatrics, Kwong Wah Hospital, Hong Kong, China
  • 12Division of Hepatobiliary, Department of Internal Medicine and Hepatitis Centre, Kaohsiung Medical University Hospital, Kaohshiung Medical University, Kaohsiung, Taiwan

Abstract

Background/Aims
Data on treatment efficacy and safety of glecaprevir/pibrentasvir (GLE/PIB) for chronic hepatitis C virus (HCV) infection in Asian patients with severe renal impairment are limited. This study aimed to study the treatment and side effects of GLE/PIB in these patients infected with non-1 genotype (GT) HCV.
Methods
We prospectively recruited patients with Child’s A cirrhosis and eGFR <30 mL/min/1.73 m2 in Hong Kong and Taiwan during 2017–2018 to receive GLE/PIB treatment.
Results
Twenty-one patients (GT2, n=7; GT3, n=6; and GT6, n=8) received GLE/PIB for 11.2±1.8 weeks. All except one were treatment-naïve. GLE/PIB was initiated in 16 patients while on dialysis (seven on peritoneal dialysis [PD] and nine on hemodialysis) and in five patients before dialysis. One patient died of PD-related peritonitis during treatment and two were lost to follow up. The SVR12 rate in the remaining 18 patients was 100%. All patients achieved undetectable levels at 4-, 12-, 24- and 48-week after treatment. Patients with deranged alanine aminotransferase showed normalization after 4 weeks and the response was sustained for 48 weeks. No significant adverse event was observed.
Conclusions
GLE/PIB treatment was associated with high efficacy and tolerability in HCV-infected patients with severe renal impairment.

Keyword

Glecaprevir and pibrentasvir; Hepatitis C; Renal insufficiency
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