STUDY OF THE EFFECT OF SOFOSBUVIR BASED THERAPY ON ESTIMATED GLOMERULAR FILTRATION RATE IN EGYPTIAN CHRONIC HEPATITIS C PATIENTS

Abstract

Introduction: Recent Hepatitis C virus (HCV) treatments, direct-acting antiviral agents (DAAS), have shown >90% efficacy in hepatitis C virus treatment and achieving the goal of a sustained virological response (SVR).Sofosbuvir acts as an inhibitor of viral RNA synthesis through suppression of "NS5B protein of the virus. Thus, it appears to have a high barrier to develop resistance. Sofosbuvir is only administered orally and mainly excreted renally. The aim of the work was to study the effect of sofosbuvir based therapy on the estimated glomerular filtration rate (eGFR) of Egyptian chronic hepatitis C patients with normal kidney function or mild renal dysfunction. Subjects and methods: This study was carried out on 100 chronic hepatitis C patients with eGFR ≥ 60 ml/ min/1.73 m2 .Before starting treatment with DAAS, all patients were subjected to full history taking, clinical examination and laboratory investigations, including: HCV PCR, HBsAg, liver function tests, complete blood picture, prothrombin activity, alfa fetoprotein, fasting blood sugar,HBA1c and renal functions. eGFR was calculated by using the Chronic kidney disease- Epidemiology Collaboration equation (CKD-ECI).All tests were repeated at the end of treatment. Also abdominal ultrasound was performed before and after treatment. Results: There were no statistically significant differences in either renal function tests or eGFR before and after treatment. There were improvements in the liver enzymes, liver functions tests and Alfa fetoprotein. Conclusions: Sofosbuvir based therapy is safe and effective in treating chronic hepatitis C patients even in patients with mild chronic kidney diseases (CKD).