Assessment of Renal Function in Post-Liver Transplant HCV-Positive Patients Treated with Direct Acting Antivirals

Figures & data

Figure 1 eGFR before treatment, end of treatment, and 6 months after completing treatment in studied groups.

Figure 2 eGFR before and at end of treatment in patients who received Ciclosporin and Tacrolimus.

Table 1 Clinical and Laboratory Data of the Two Studied Groups Before Treatment

Variables	Group I Sofosbuvir + Ribavirin (n=51)	Group II Sofosbuvir + Daclatasvir (n=33)	Test	P
Age (years)	52.63±4.44	50.85±6.26	1.52	0.131
Gender:
Male (n) (%)  Female (n) (%)	38 (74.5) 13 (25.5)	28 (84.8) 5 (15.2)	1.27*	0.29
HCC:
Yes (n) (%)  No (n) (%)	12 (23.5) 39 (76.5)	5 (13.3) 28 (85.7)	0.87*	0.26
Diabetes:
Yes (n) (%)  No (n) (%)	41 (80.4) 10 (19.6)	28 (84.8) 5 (15.2)	0.27*	0.77
Hypertension:
Yes (n) (%)  No (n) (%)	43 (84.3) 8 (15.7)	30 (90.9) 3 (9.1)	0.77*	0.52
Immunosuppression
Tacrolimus (n) (%)  Ciclosporin (n) (%)	39 (76.5) 12 (23.5)	25 (75.8) 8 (24.2)	0.006*	1.00
Duration of Tx (years)	8.18±1.62	7.61±1.22	1.73^#	0.09
Start of treatment after transplantation (years)	3.14±0.80	2.91±0.27	1.32^#	0.19
Tacrolimus trough level (ng/mL)	6.67±3.43	6.00±2.08	0.87^#	0.39
Ciclosporin C2 level (ng/mL)	365.92±132.55	350.14±84.90	0.001^$	0.99
Bilirubin (mg/dL)	1.08±0.47	1.09±0.55	−0.09^#	0.95
Albumin (g/L)	3.82±0.75	3.88±0.55	−1.03^#	0.30
ALT (IU/L)	45.20±22.83	49.21±24.71	−0.78^#	0.45
AST (IU/L)	55.71±40.36	43.88±17.91	−0.82^$	0.75
ALP (IU/L)	234.57±205.45	202.70±112.69	0.81^$	0.42
INR	0.99±0.07	1.02±0.11	−1.23^#	0.22
Hb A1c	5.66±1.25	5.62±0.99	0.17^#	0.87
Na (mmol/L)	135.41±4.28	135.76±3.93	−0.37^#	0.71
K (mmol/L)	4.44±0.53	4.60±0.56	−1.32^#	0.19
CRP	7.35±5.35	8.29±6.50	−0.32^$	0.75
Hb (g/dL)	13.21±2.01	13.64±1.63	−1.03^#	0.31
WBCs	6.07±1.93	5.63±1.99	1.007^#	0.32
Platelets	196.82±91.78	182.33±85.66	0.73^$	0.47
Uric acid mg/dL	6.96±2.04	6.65±1.30	−1.32^#	0.19
Urea (mg/dL)	42.63±17.52	38.64±14.21	1.10^#	0.39
Creatinine (mg/dL)	0.94±0.18	0.96±0.16	−0.58^#	0.57
eGFR (mL/min)	87.36±15.23	88.51±14.99	−0.34^#	0.73

Notes: *Chi^{2, #}t-test, ^$Mann-Whitney test.

Abbreviations: ALT, alanine aminotransferase; AST, aspartate aminotransferase; ALP, alkaline phosphatase; INR, International Normalized Ratio; HCC, hepatocellular carcinoma; CRP, C reactive protein; Hb, hemoglobin; WBCs, white blood cells; eGFR, estimated glomerular filtration rate; Tx, transplantation.

Table 2 Comparison of Laboratory Data Before and After Treatment with DAAs

Variables	Group I Sofosbuvir + Ribavirin (n=51)			Group II Sofosbuvir + Daclatasvir (n=33)
	Pre-treatment	Post-treatment (EOT 24)	P*	Pre-treatment	Post-treatment (EOT 12)	P*
Tacrolimus trough level (ng/mL)	6.67±3.43	5.99±3.27	0.10	6.00±2.08	5.83±1.73	0.65
Ciclosporin C2 level (ng/mL)	365.92±132.55	439.42±163.84	0.28	350.14±84.89	478.57±152.58	0.052
Bilirubin (mg/dL)	1.08±0.47	1.56±1.79	0.048	1.09±0.55	1.20±0.75	0.12
Albumin (g/L)	3.82±0.75	3.81±0.79	0.93	3.98±0.55	4.00±0.59	0.80
ALT (IU/L)	45.20±22.83	52.10±33.01	0.014	49.21±24.71	50.12±36.67	0.91
AST (IU/L)	55.71±40.36	62.33±42.15	0.034	43.88±17.91	48.70±37.35	0.42
ALP (IU/L)	234.57±205.45	247.02±192.42	0.42	202.70±112.69	196.55±98.21	0.64
INR	0.99±0.07	1.04±0.12	0.014	1.02±0.11	1.04±0.13	0.63
Hb A1c	5.66±1.26	5.53±1.23	0.28	5.62±0.99	5.69±0.94	0.48
Na (mmol/L)	135.41±4.28	136.51±3.79	0.07	135.76±3.93	136.58±3.61	0.26
K (mmol/L)	4.44±0.50	4.48±0.56	0.59	4.60±0.56	4.33±0.61	0.11
CRP	7.35±5.35	8.99±7.76	0.07	8.29±6.50	8.07±7.10	0.87
Hb (g/dL)	13.21±2.01	13.07±20.00	0.41	13.64±1.63	13.7±1.8	0.54
WBCs	6.07±1.93	6.50±2.34	0.06	5.63±1.99	6.13±3.82	0.34
Platelets	196.82±91.78	157.04±68.36	0.001	182.33±85.66	147.61±65.65	0.002
Uric acid (mg/dL)	6.96±2.04	8.30±2.58	0.001	6.65±1.30	7.79±2.41	0.04
Urea (mg/dL)	42.63±17.52	64.49±46.77	0.001	38.64±14.21	45.18±26.77	0.15
Creatinine (mg/dL)	0.94±0.18	1.14±0.47	0.003	0.96±0.16	0.99±0.19	0.30
eGFR (mL/min)	87.36±15.23	76.16±22.40	0.001	88.51±14.99	86.00±16.13	0.29

Note: *P-value for t-test.

Abbreviations: ALT, alanine aminotransferase; AST, aspartate aminotransferase; INR, International Normalized Ratio; ALP, alkaline phosphatase; CRP, c-reactive protein; Hb, hemoglobin; WBCs, white blood cells; eGFR, estimated glomerular filtration rate.