Influence of daclatasvir hydrochloride combined with asunaprevir on renal function in patients with compensated hepatitis C cirrhosis

Objective To investigate the influence of daclatasvir hydrochloride combined with asunaprevir on renal function in patients with compensated hepatitis C cirrhosis. Methods A total of 44 previously untreated patients with compensated hepatitis C cirrhosis caused by hepatitis C virus genotype 1 b infection who visited Department of Infectious Diseases in Tangdu Hospital, Fourth Military Medical University, from May 2017 to September 2017 were enrolled. All patients were given oral daclatasvir hydrochloride ( 60 mg, once a day) combined with asunaprevir ( 100 mg, twice a day) as the antiviral therapy, and the course of treatment was 24 weeks. The changes in HCV RNA clearance rate, alanine aminotransferase ( ALT) normalization rate, blood urea nitrogen, creatinine, and estimated glomerular filtration rate ( eGFR) were measured from baseline to weeks 4 and 24 of treatment were observed, and eGFR was calculated using the Modification of Diet In Renal Disease ( MDRD) and Chronic Kidney Disease Epidemiology Collaboration ( CKD-EPI) equations. The chi-squared test was used for comparison of normally distributed continuous data between groups, and the SNK-q test was used for further comparison between two groups. Results At week 24 of treatment, the HCV RNA clearance rate was 100% ( 44/44) and the ALT normalization was 97. 50% ( 39/40) . There was a significant increase in blood urea nitrogen from baseline ( 4. 43 ± 1. 09 mmol/L) to week 24 of treatment ( 4. 91 ± 1. 41 mmol/L) ( q = 2. 322, P = 0. 025) , while there was no significant change in creatinine from baseline to week 4 or 24 of treatment ( both P> 0. 05) . There was no significant change in eGFR calculated using either MDRD or CKD-EPI equation from baseline to week 4 or 24 of treatment ( both P > 0. 05) . As for the 14 patients with a baseline eGFR of < 90 ml/min/1. 73 m2 calculated using the MDRD equation, they had a significant increase in eGFR from baseline ( 82. 81 ± 7. 16 ml/min/1. 73 m2) to week 24 of treatment ( 89. 65 ± 15. 85 ml/min/1. 73 m2) ( q = 2. 303, P = 0. 038) . Conclusion Daclatasvir hydrochloride combined with asunaprevir has no significant influence on renal function in patients with compensated hepatitis C cirrhosis, and there is a need for more studies with a large sample size.