Pharmacokinetics, Efficacy, and Safety of Hepatitis C Virus Drugs in Patients with Liver and/or Renal Impairment

Hepatitis C virus (HCV)-infected patients often suffer from liver cirrhosis, which can be complicated by renal impairment. Therefore, in this review we describe the treatment possibilities in HCV patients with hepatic and renal impairment. Cirrhosis alters the structure of the liver, which affects d...

Full description

Saved in:
Bibliographic Details
Published in:Drug safety 2016-07, Vol.39 (7), p.589-611
Main Authors: Smolders, Elise J., de Kanter, Clara T. M. M., van Hoek, Bart, Arends, Joop E., Drenth, Joost P. H., Burger, David M.
Format: Article
Language:English
Subjects:
Drug dosages
Drug Safety and Pharmacovigilance
Enzymes
Funding
Hemodialysis
Hepatitis
Hepatitis C virus
Kidney diseases
Liver cirrhosis
Liver diseases
Medicine
Medicine & Public Health
Mortality
Pharmacology/Toxicology
Prescription drugs
Proteins
Review
Review Article
Rodents
Studies
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Hepatitis C virus (HCV)-infected patients often suffer from liver cirrhosis, which can be complicated by renal impairment. Therefore, in this review we describe the treatment possibilities in HCV patients with hepatic and renal impairment. Cirrhosis alters the structure of the liver, which affects drug-metabolizing enzymes and drug transporters. These modifications influence the plasma concentration of substrates of drugs metabolized/transported by these enzymes. The direct-acting antivirals (DAAs) are substrates of, for example, cytochrome P450 enzymes in the liver. Most DAAs are not studied in HCV-infected individuals with decompensated cirrhosis, and therefore awareness is needed when these patients are treated. Most DAAs are contraindicated in cirrhotic patients; however, patients with a Child-Pugh score of B or C can be treated safely with a normal dose sofosbuvir plus ledipasvir or daclatasvir, in combination with ribavirin. Patients with renal impairment (glomerular filtration rate [GFR]
ISSN:0114-5916
1179-1942
DOI:10.1007/s40264-016-0420-2