@article {247218, title = {Serial changes in renal indices in chronic HCV patients with and without HIV co-infection receiving sofosbuvir and tenofovir-based therapies.}, journal = {Transactions of the Royal Society of Tropical Medicine and Hygiene}, volume = {117}, year = {2023}, pages = {285-296}, abstract = {

BACKGROUND: Sofosbuvir (SOF) is authorized for hepatitis C virus (HCV) patients. The nephrotoxicity of SOF on HCV mono-infected and HCV-human immunodeficiency virus (HIV) individuals receiving antiretroviral therapy (ART) remains controversial.

METHODS: A prospective study including 159 HCV mono-infected and 124 HCV-HIV individuals (47 were ART na{\"\i}ve and 77 were tenofovir [TDF]-based ART) who presented with an estimated glomerular filtration rate (eGFR) >=30~ml/min/1.73~m2 at baseline and were treated with SOF-daclatasvir for 12~weeks. The eGFR was estimated using the Chronic Kidney Disease Epidemiology Collaboration equation over the study period.

RESULTS: HCV patients had a progressive decline in median levels of eGFR compared with HCV-HIV patients who were ART na{\"\i}ve and those receiving TDF-based ART during and after discontinuing SOF-DAC treatment (96, 109 and 114 at baseline vs 94, 117 and 108 at the end of treatment [EOT]) vs 95, 114 and 115~ml/min/1.73~m2 at 12~weeks after treatment [SVR12], respectively). Moreover, the rate of eGFR stage worsening was more pronounced in HCV mono-infected compared with HCV-HIV individuals who were ART na{\"\i}ve and those receiving TDF-based ART (21.4\% vs 8.5\% and 14.3\% at EOT; 21.4\% vs 2.1\% and 6.5\% at SVR12, respectively). Multivariable regression analysis showed that baseline variables were not independent predictors of eGFR stage worsening either at EOT or SVR12.

CONCLUSIONS: Because the changes in eGFR were minimal and not of clinical significance, and TDF was not associated with an increase in renal dysfunction, SOF-based direct-acting antivirals could be safely used in HCV mono-infected and HCV-HIV individuals, even in those on TDF-based ART.

}, author = {Shereen Abdel Alem and El Garhy, Naeema and Engy El Khateeb and Khalil, Mahmoud and Cordie, Ahmed and Elsharkawy, Aisha and Fouad, Rabab and Gamal Esmat and Abdelbary, Mohammad Salah} }