Managing hepatitis C therapy failures and chronic kidney disease.

Managing hepatitis C therapy failures and chronic kidney disease. Expert Rev Clin Pharmacol. 2018 Oct 12;: Authors: Fabrizi F, Messa P Abstract Introduction Hepatitis C virus (HCV) infection leads to important morbidity and mortality through liver disease and extra-hepatic manifestations. Recent evidence suggests the role of HCV in developing chronic kidney disease (CKD); also, HCV adversely impacts on cardiovascular (CV) disease both in the general population and in patients with CKD. Areas covered All-oral, interferon-free direct-acting antiviral agents are currently available; anti-HCV regimens based on direct-acting antiviral agents (DAAs) are provided with high efficacy and safety and short treatment duration. However, some difficult-to-treat populations still exist including patients with CKD and those who failed previous DAA regimen. Expert commentary Two DAAs regimens (elbasvir/grazoprevir and glecaprevir/pibrentasvir) are now recommended for the treatment of HCV in patients with advanced CKD, these combinations have shown great efficacy, according to two multicenter phase 3 trials (C-SURFER and EXPEDITION-4). These trials reported a minimal impact of baseline resistance-associated substitutions (RASs) on treatment outcomes. The sofosbuvir/velpatasvir/voxaliprevir combination has been recommended as the first-line option for DAAs failures, on the basis of the results given by two randomized clinical trials involving patients ...
Source: Pharmacological Reviews - Category: Drugs & Pharmacology Authors: Tags: Expert Rev Clin Pharmacol Source Type: research