Back to Search
Start Over
The impact of antiviral therapy for HCV on kidney disease: a systematic review and meta-analysis.
- Source :
-
Nefrologia [Nefrologia (Engl Ed)] 2020 May - Jun; Vol. 40 (3), pp. 299-310. Date of Electronic Publication: 2019 Dec 06. - Publication Year :
- 2020
-
Abstract
- Background: Controversy persists about the role of hepatitis C as a risk factor for developing kidney disease in the general population. Some authors have evaluated the effect of antiviral therapy for HCV on the risk of kidney disease.<br />Study Aims and Design: A systematic review of the published medical literature was performed to assess whether antiviral therapy for HCV has an independent impact on kidney survival in the adult general population. A random effects model was used to generate an overall estimate of the risk of kidney disease after anti-HCV therapy across the published studies. Meta-regression and stratified analysis were also carried out.<br />Results: Fifteen studies were eligible (n=356, 285 patients) and separate meta-analyses were conducted according to the outcome. Pooling studies based on viral responses (n=7; 34,763 individual patients) demonstrated a relationship between sustained viral response and lower frequency of kidney disease; the overall estimate for adjusted risk of kidney disease was 2.50 (95% CI, 1.41; 4.41) (p=0.0016) and between-study heterogeneity was found (p-value by Q test=0.004). Aggregation of studies comparing treated vs untreated cohorts (n=8, n=333,312 patients) revealed an association between anti-HCV therapy and lower risk of kidney disease. The overall estimate for adjusted risk of kidney disease across the eight studies was 0.39 (95% CI, 0.25; 0.612) (p=0.0001). Meta-regression showed that the effectiveness of antiviral therapy in reducing the frequency of kidney disease diminishes as cirrhosis (p=0.02) and HBV infection (p=0.0001) increase among HCV-infected individuals.<br />Conclusions: Antiviral therapy for HCV lowers the risk of kidney disease among HCV-infected individuals. Studies to understand the mechanisms underlying this association are ongoing.<br /> (Copyright © 2019. Published by Elsevier España, S.L.U.)
- Subjects :
- Adult
Aged
Aged, 80 and over
Disease Progression
Female
Follow-Up Studies
Hepatitis C, Chronic complications
Humans
Incidence
Interferons therapeutic use
Liver Cirrhosis etiology
Liver Cirrhosis prevention & control
Male
Middle Aged
Renal Insufficiency, Chronic epidemiology
Renal Insufficiency, Chronic etiology
Risk
Treatment Outcome
Antiviral Agents therapeutic use
Hepatitis C, Chronic drug therapy
Renal Insufficiency, Chronic prevention & control
Subjects
Details
- Language :
- English; Spanish; Castilian
- ISSN :
- 2013-2514
- Volume :
- 40
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Nefrologia
- Publication Type :
- Academic Journal
- Accession number :
- 31813592
- Full Text :
- https://doi.org/10.1016/j.nefro.2019.07.007