Background: Chronic hepatitis C virus (HCV) infection remains a major global health concern and is associated with chronic kidney disease (CKD). HCV infection may represent both a contributing factor to the development of chronic kidney disease (as an extrahepatic manifestation) and a consequence of CKD-related exposures, particularly in patients undergoing dialysis. Historically, patients with advanced CKD and those undergoing dialysis had limited and poorly tolerated antiviral treatment options. The advent of direct-acting antivirals, including the fixed-dose combination of glecaprevir/pibrentasvir (G/P), has substantially changed therapeutic management in this high-risk population. Aim: To summarize current evidence regarding the efficacy and safety of G/P therapy in adults with HCV infection and concomitant CKD, including patients receiving hemodialysis or peritoneal dialysis. Methods: A narrative review of the literature was conducted using the PubMed/MEDLINE database. Studies published within the last six years reporting original clinical data on adults with CKD treated with G/P were included. Phase III trials and real-world cohort studies were analyzed, focusing on sustained virologic response at 12 weeks (SVR12) and safety outcomes. Results: Across clinical trials and large real-world cohorts, G/P achieved SVR12 rates ranging from 97% to 100%, irrespective of CKD stage, dialysis status, or HCV genotype. The regimen was well tolerated, with predominantly mild adverse events and no clinically significant deterioration in renal function. Conclusion: Glecaprevir/pibrentasvir demonstrates high antiviral efficacy and a favorable safety profile in patients with CKD, including those undergoing dialysis.
Krawczyk et al. (Mon,) studied this question.