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

Clinical and Molecular Hepatology 2020년 26권 4호 p.554 ~ 561
Yap Desmond Y. H., Liu Kevin S. H., Hsu Yu-Chun, Wong Grace L. H., Tsai Ming-Chang, Chen Chien-Hung, Hsu Ching-Sheng, Hui Yee Tak, Li Michael K. K., Yuen Man-Fung,
소속 상세정보
 ( Yap Desmond Y. H. ) - University of Hong Kong Queen Mary Hospital Department of Medicine
 ( Liu Kevin S. H. ) - University of Hong Kong Queen Mary Hospital Department of Medicine
 ( Hsu Yu-Chun ) - Changhua Christian Hospital Department of Internal Medicine
 ( Wong Grace L. H. ) - Chinese University of Hong Kong Prince of Wales Hospital Department of Medicine and Therapeutics
 ( Tsai Ming-Chang ) - Chung Shan Medical University Hospital Department of Internal Medicine
 ( Chen Chien-Hung ) - National Taiwan University Hospital Yunlin Branch Department of Internal Medicine
 ( Hsu Ching-Sheng ) - Buddhist Tzu Chi Medical Foundation Taipei Tzu Chi Hospital Liver Diseases Research Centre
 ( Hui Yee Tak ) - Queen Elizabeth Hospital Department of Medicine
 ( Li Michael K. K. ) - Tuen Mun Hospital Department of Medicine and Geriatrics
 ( Yuen Man-Fung ) - University of Hong Kong Queen Mary Hospital Department of Medicine

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-naive. 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.

키워드

Glecaprevir and pibrentasvir; Hepatitis C; Renal insufficiency

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