Abstract

Background

Direct-acting antiviral agents (DAAs) have shown high rates of sustained virological response in chronic hepatitis C virus (HCV) infection. However, the influence of DAAs on the course of kidney involvement in HCV-associated mixed cryoglobulinaemia (HCV-MC) has been little studied. The aim of this study was to analyse the effects of antiviral treatment on kidney prognosis and evolution in patients diagnosed with HCV-MC.

Methods

The RENALCRYOGLOBULINEMIC study is an observational multicentre cohort study of 139 patients with HCV-MC from 14 Spanish centres. Clinical and laboratory parameters were measured before and after antiviral treatment. Primary endpoints were kidney survival and mortality after HCV-MC diagnosis. Secondary endpoints were clinical, immunological and virological responses after antiviral treatment.

Results

Patients were divided into three groups based on the treatment received: treatment with DAAs (n = 100) treatment with interferon (IFN) and ribavirin (RBV) (n = 24) and no treatment (n = 15). Patients were followed up for a median duration of 138 months (interquartile range 70–251. DAA treatment reduced overall mortality {hazard ratio [HR] 0.12 [95% confidence interval (CI) 0.04–0.40]; P < 0.001} and improved kidney survival [HR 0.10 (95% CI 0.04–0.33); P < 0.001].

Conclusions

Results from the RENALCRYOGLOBULINEMIC study indicated that DAA treatment in patients with HCV-MC improves kidney survival and reduces mortality.

Details

Title
Direct-acting antiviral therapy improves kidney survival in hepatitis C virus-associated cryoglobulinaemia: the RENALCRYOGLOBULINEMIC study
Author
Pérez de José, Ana 1 ; Carbayo, Javier 1 ; Pocurull, Anna 2 ; Bada-Bosch, Teresa 3 ; Cases Corona, Clara Maria 4 ; Shabaka, Amir 5 ; Natàlia Ramos Terrada 6 ; Laura Martinez Valenzuela 7 ; Huerta, Ana 8 ; Loreto Fernandez Lorente 9 ; Malek-Marín, Tamara Gelen 10 ; Goicoechea, Marian 1 

 Department of Nephrology, University Hospital Gregorio Marañón, Madrid, Spain 
 Department of Gastroenterology and Hepatology, Hospital Clínic de Barcelona, Barcelona, Spain 
 Department of Nephrology, Hospital Universitario Doce de Octubre, Madrid, Spain 
 Department of Nephrology, Hospital Universitario Fundacion Alcorcon, Madrid, Spain 
 Department of Nephrology, Hospital Clínico Universitario San Carlos, Madrid, Spain 
 Department of Nephrology, Hospital Vall d'Hebron, Barcelona, Spain 
 Department of Nephrology, Hospital Universitari de Bellvitge, Catalunya, Spain 
 Department of Nephrology, Hospital Universitario Puerta del Hierro Majadahonda, Madrid, Spain 
 Department of Nephrology, Hospital de Navarra, Pamplona, Spain 
10  Department of Nephrology, Hospital de Sagunto, Sagunto, Spain 
Pages
586-592
Publication year
2021
Publication date
Feb 2021
Publisher
Oxford University Press
ISSN
20488505
e-ISSN
20488513
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
3169586272
Copyright
© The Author(s) 2020. Published by Oxford University Press on behalf of ERA-EDTA. This work is published under http://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.