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Research Article

JCDR. 2021; 12(5): 775-756


Effects Of Direct Acting Antivirals on Glomerular Filtration Rates and Neutrophil Gelatinase-Associated Lipocalin During Treatment of Hepatitis C Patients

Michael George Nada, Ehab Hasan Nashaat, Ahmed Ibrahim Elshafie, Ghada Abdelrahman Mohamed, Walaa Mohamed Hashem.


Abstract

Background
Direct acting antivirals (DAA) havesignificantly contributed to the treatment protocol for chronic hepatitis C (CHC),
nonetheless, there are concerns regarding their safety especially in patients with chronic kidney disease (CKD).
Neutrophil gelatinase-associated lipocalin (NGAL) is an emerging biomarker for renal tubular injury. Herein, we
aimed to estimate the changes in serum NGAL levelsfollowing DAA-therapy, as well as to investigate the diagnostic
reliability of serum NGAL in case of potential DAA-related nephrotoxicity. We consecutively enrolled 80treatmentnaïve
adult CHC patients who were eligible for DAA-therapy. We further categorizedthe patients into 2 groups,
group I included 40 patients with normal kidney functions who received SOF/DAC for 12-weeks, whereas group II
included 40 CKD patients who received OBV/PTV/r + RBV for 12-weeks. In addition, 20 healthy participants with
matched age and sex were enrolled as controls.The serum NGAL level was measured at baseline and at the end of
therapy(EOT) using an Enzyme-Linked Immunosorbent Assay (ELISA).
Results
At EOT compared to baseline, serum NGAL levels were significantlydecreased in group I (271 ± 77.24 vs 167.3 ±
89.19 ng/mL, P2.
Conclusion
DAA are not only safe to use in CKD patients, but also has an additive beneficial effect on the renal tubules via
HCV eradication as indicated by the significant decline in serum NGAL levels.

Key words: Antiviral agents; Hepatitis C virus; Inflammation; Neutrophil Gelatinase-Associated Lipocalin Protein; Kidney Tubule; Sofosbuvir; Paritaprevir; Acute Kidney Injury






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