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• W4310500612 abstract "IntroductionDirect-acting antivirals (DAAs) have improved treatment of hepatitis C virus (HCV) infection in patients with chronic kidney disease (CKD). To facilitate the 2022 update of the Kidney Disease: Improving Global Outcomes (KDIGO) guideline for CKD patients with HCV, we systematically reviewed DAA regimens in patients with CKD stages G4 and G5 nondialysis (G4–G5ND), CKD stage G5 on dialysis (G5D), and kidney transplant recipients (KTRs).MethodsWe conducted a systematic review by searching PubMed, Embase, Cochrane, CINAHL, and ClinicalTrials.gov through February 1, 2022, and conferences from 2019 to 2021. Studies of HCV-infected patients with CKD G4–G5ND, G5D, and KTRs treated with specified DAA regimens were included. Outcomes included death at 6 months or later, sustained virologic response at 12 weeks (SVR12), serious adverse events (SAEs) attributed to DAA, and treatment discontinuation because of adverse events. Maximum likelihood meta-analyses were determined; certainty of evidence was assessed per GRADE (Grading of Recommendations Assessment, Development, and Evaluation).ResultsWe identified 106 eligible studies (22 reported on CKD G4–G5ND, 69 on CKD G5D, and 29 on KTRs). In each population, the majority of DAA regimens achieved SVR12 ≥ 93%. We found generally low quality of evidence of low risk of SAEs (mostly 0%, up to 2.9%) and low risk of discontinuation because of adverse events (mostly 0%−5%). Across 3 unadjusted observational studies in KTRs, the risk of death after DAA treatment was substantially lower than without treatment (summary odds ratio, 0.16; 95% CI, 0.04–0.61).ConclusionCombination DAA regimens are safe and highly effective in patients with advanced CKD, on dialysis, and with kidney transplants." @default.
• W4310500612 created "2022-12-11" @default.
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• W4310500612 creator A5056355381 @default.
• W4310500612 creator A5059680403 @default.
• W4310500612 date "2023-02-01" @default.
• W4310500612 modified "2023-10-01" @default.
• W4310500612 title "A Systematic Review of Direct-Acting Antivirals for Hepatitis C in Advanced CKD" @default.
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