title: Anti-hepatitis C virus drugs and kidney.
abstract: Hepatitis C virus (HCV) mainly targets the liver but can also induce extrahepatic manifestations. The kidney may be impactedviaan immune mediated mechanism or a cytopathic effect. HCV patients are clearly at a greater risk of chronic kidney disease (CKD) than uninfected patients are, and the presence of CKD increases mortality. Interferon-based therapies and ribavirin are difficult to manage and are poorly effective in end-stage renal disease and hemodialysis. These patients should be given priority treatment with new direct anti-viral agents (DAAs) while avoiding peginterferon and ribavirin. The first results were convincing. To aid in the correct use of these drugs in patients with renal insufficiency, their pharmacokinetic properties and potential renal toxicity must be known. The renal toxicity of these new drugs was not a safety signal in clinical trials, and the drugs are generally efficient in these frail populations. These drugs are usually well tolerated, but recent cohort studies have demonstrated that these new regimens may be associated with renal side effects, especially when using sofosbuvir combinations. HCV, renal diseases and comorbidities are intimately linked. The close monitoring of renal function is required, particularly for at-risk patients (transplanted, HIV-coinfected, CKD, hypertensive or diabetic patients). New DAA regimens, which will soon be approved, will probably change the landscape.
authors.affiliation: Paul Carrier, Marie Essig, Marilyne Debette-Gratien, Annick Rousseau, Pierre Marquet, Véronique Loustaud-Ratti, U850 INSERM, Université de Limoges, 87000 Limoges, France.
authors.forename: Paul
authors.initials: P
authors.lastname: Carrier
authors.affiliation: Paul Carrier, Marie Essig, Marilyne Debette-Gratien, Annick Rousseau, Pierre Marquet, Véronique Loustaud-Ratti, U850 INSERM, Université de Limoges, 87000 Limoges, France.
authors.forename: Marie
authors.initials: M
authors.lastname: Essig
authors.affiliation: Paul Carrier, Marie Essig, Marilyne Debette-Gratien, Annick Rousseau, Pierre Marquet, Véronique Loustaud-Ratti, U850 INSERM, Université de Limoges, 87000 Limoges, France.
authors.forename: Marilyne
authors.initials: M
authors.lastname: Debette-Gratien
authors.affiliation: Paul Carrier, Marie Essig, Marilyne Debette-Gratien, Annick Rousseau, Pierre Marquet, Véronique Loustaud-Ratti, U850 INSERM, Université de Limoges, 87000 Limoges, France.
authors.forename: Denis
authors.initials: D
authors.lastname: Sautereau
authors.affiliation: Paul Carrier, Marie Essig, Marilyne Debette-Gratien, Annick Rousseau, Pierre Marquet, Véronique Loustaud-Ratti, U850 INSERM, Université de Limoges, 87000 Limoges, France.
authors.forename: Annick
authors.initials: A
authors.lastname: Rousseau
authors.affiliation: Paul Carrier, Marie Essig, Marilyne Debette-Gratien, Annick Rousseau, Pierre Marquet, Véronique Loustaud-Ratti, U850 INSERM, Université de Limoges, 87000 Limoges, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Marquet
authors.affiliation: Paul Carrier, Marie Essig, Marilyne Debette-Gratien, Annick Rousseau, Pierre Marquet, Véronique Loustaud-Ratti, U850 INSERM, Université de Limoges, 87000 Limoges, France.
authors.forename: Jérémie
authors.initials: J
authors.lastname: Jacques
authors.affiliation: Paul Carrier, Marie Essig, Marilyne Debette-Gratien, Annick Rousseau, Pierre Marquet, Véronique Loustaud-Ratti, U850 INSERM, Université de Limoges, 87000 Limoges, France.
authors.forename: Véronique
authors.initials: V
authors.lastname: Loustaud-Ratti
keywords: Direct anti-viral agents; End-stage renal disease; Hepatitis C; Kidney; Nephrotoxicity