Renal impairment in patients with chronic hepatitis C treated with first generation protease inhibitors

<div><p><b><i>Background</i></b>: The incidence, course and risk factors associated with renal impairment (RI) in patients treated with triple therapy (TT) with pegylated interferon, ribavirin and telaprevir/boceprevir (PR/TVR/BOC) vs. dual therapy (DT) with PR were analyzed in this study. The association between RI and the decline of hemoglobin (Hb) was also examined.</p><p><b><i>Methods</i></b>: Retrospective analysis included 110 patients with genotype 1b chronic HCV infection, aged 18 – 80 years, who underwent TT (48TVR/14BOC) or DT (48 patients). The estimated glomerular filtration rate (eGFR), serum creatinine concentration (SCr) and Hb were measured at baseline, at weeks 4, 12, 24, 48 of treatment, and post-treatment week 24.</p><p><b><i>Results</i></b>: RI occurred in 9/62 (14.5%) patients who underwent TT, eight of whom were treated with TVR, one with BOC, and none treated with DT. The risk factors associated with RI were the following: TT (p = 0.0078), usage of nephrotoxic drugs (p = 0.0288), and older age (p < 0.0001). RI was reversible. A drop of Hb was associated with RI, older age and TT.</p><p><b><i>Conclusions</i></b>: RI is not a rare but a reversible complication of TT. It is necessary to monitor SCr and eGFR, especially in patients with a potential risk factor of RI occurrence. The Hb drop is more severe in patients with RI than in those without it.</p></div

Patient characteristics in the whole group and according to HBeAg status.

<p>Patient characteristics in the whole group and according to HBeAg status.</p

Safety through 48 months of therapy among all ETV-treated patients.

<p>Safety through 48 months of therapy among all ETV-treated patients.</p

Factors associated with the loss of HBV DNA and normalization of ALT activity (multivariate GEE models).

<p>Factors associated with the loss of HBV DNA and normalization of ALT activity (multivariate GEE models).</p

Factors associated with the loss of HBeAg(-) and attainment of SRR (multivariate GEE models).

<p>Factors associated with the loss of HBeAg(-) and attainment of SRR (multivariate GEE models).</p

Significance of virological parameters in predicting long-term virological suppression and SRR among children and adolescent with CHB.

<p>Significance of virological parameters in predicting long-term virological suppression and SRR among children and adolescent with CHB.</p

Treatment responses at 12 months of therapy in the whole group and according to HBeAg status.

<p>Treatment responses at 12 months of therapy in the whole group and according to HBeAg status.</p

Longitudinal changes in virological, biochemical and serological responses in subsequent months of ETV therapy in HBeAg(+) and HBeAg(-) patients at baseline.

<p>Frequencies of HBV DNA <20 IU/mL, normal ALT activity (<40 IU/L), loss of HBeAg and achievement of SRR during ETV therapy in HBeAg(-) (A) and HBeAg(+) (B) patients were calculated. Cumulative rates of viral suppression to undetectable HBV DNA (<20 IU/mL) were determined in patients stratified by HBeAg status (C). The cumulative rate of HBeAg seroconversion was calculated in the subgroup of HBeAg(+) patients (D).</p

The impact of ETV therapy on growth in CHB adolescents.

<p>The impact of ETV therapy on growth in CHB adolescents.</p