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Muñoz-Gómez R, Rincón D, Ahumada A, Hernández E, Devesa MJ, Izquierdo S, Ortiz M, Hernández-Albujar A, Fernández-Rodríguez C, Calvo M, González R, Lozano M, Castellano G, Fernández-Vázquez I. Therapy with ombitasvir/paritaprevir/ritonavir plus dasabuvir is effective and safe for the treatment of genotypes 1 and 4 hepatitis C virus (HCV) infection in patients with severe renal impairment: A multicentre experience. J Viral Hepat 2017; 24:464-471. [PMID: 27976490 DOI: 10.1111/jvh.12664] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Accepted: 11/28/2016] [Indexed: 12/16/2022]
Abstract
Limited data are available on direct-acting antivirals for treating hepatitis C virus (HCV) infection in patients with severe renal impairment. The aim of this study was to evaluate the effectiveness and safety of ombitasvir/paritaprevir/ritonavir (OBV/PTV/r) ± dasabuvir (DSV) ± ribavirin (RBV) in patients with stage 4 or 5 chronic kidney disease (CKD) and HCV genotype 1 or 4 infection in real clinical practice, and to investigate pharmacological interactions. This retrospective study included patients treated with OBV/PTV/r+DSV±RBV or OBV/PTV/r+RBV with CKD stage 4 (eGFR: 15-29 mL/min/1.73m2 ) or 5 (eGFR<15 mL/min/1.73m2 or requiring dialysis) and HCV infection by genotypes 1 and 4 between April 2015 and October 2015 in nine Spanish centres. Sustained virological response at 12 weeks (SVR12) was assessed, and clinical and laboratory data, fibrosis stage, adverse events and pharmacological interactions were reported. Forty-six patients were included: 10 (21.7%) had CKD stage 4 and 36 (78.2%) CKD stage 5. Seventeen (36.9%) had cirrhosis. SVR12 rate in the intention-to-treat population was 95.7%. Twenty-one (45.6%) received RBV, which was discontinued in two (9.5%) patients. Anaemia (haemoglobin <10 g/dl) occurred in 12 patients (57.1%) with RBV vs 10 (40.0%) without RBV (P=.246). Renal function remained stable during antiviral therapy. Nine patients (19.5%) experienced serious adverse events unrelated to antiviral therapy. Concomitant medication was discontinued or modified in 41.3% of patients. In conclusion, the effectiveness of OBV/PTV/r±DSV±RBV in patients with CKD 4-5 was similar to that observed in those with normal renal function and was not associated with severe adverse events.
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Affiliation(s)
- R Muñoz-Gómez
- Department of Gastroenterology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - D Rincón
- Unit of Hepatology, Hospital Universitario Gregorio Marañón, CIBERehd , Madrid, Spain
| | - A Ahumada
- Unit of Hepatology, Hospital Universitario Gregorio Marañón, CIBERehd , Madrid, Spain
| | - E Hernández
- Department of Nephrology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - M J Devesa
- Department of Gastroenterology, Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - S Izquierdo
- Department of Gastroenterology, Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - M Ortiz
- Department of Gastroenterology, Hospital Universitario Infanta Cristina, Madrid, Spain
| | - A Hernández-Albujar
- Department of Gastroenterology, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
| | - C Fernández-Rodríguez
- Department of Gastroenterology, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - M Calvo
- Department of Gastroenterology, Complejo Asistencial de Segovia, Segovia, Spain
| | - R González
- Department of Gastroenterology, Hospital Universitario del Sureste, Madrid, Spain
| | - M Lozano
- Department of Gastroenterology, Hospital Universitario Infanta Leonor, Madrid, Spain
| | - G Castellano
- Department of Gastroenterology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - I Fernández-Vázquez
- Department of Gastroenterology, Hospital Universitario 12 de Octubre, Madrid, Spain
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Durán FG, Senent C, Pérez de Ayala V, Menchén P, Robles J, Cos E, Hernández-Albujar A. [Urticariform reaction: endoscopic diagnosis]. Rev Esp Enferm Dig 1996; 88:713-4. [PMID: 8983314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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García Durán F, Baños E, Hernández-Albujar A, Pérez de Ayala V, Jiménez P, Menchén P, Cos E, Senent C. [Idiopathic esophageal ulcer with fistulization to the bronchial tree in a HIV-positive patient]. Rev Esp Enferm Dig 1996; 88:133-6. [PMID: 8664069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Idiopathic esophageal ulcerations (IEUs) associated with human immunodeficiency virus (HIV) infection are now recognized as an important cause of esophageal disease in this population. We report one case of IEU complicated with a fistula to the bronchial tree. Given his variable appearance, which may mimic other causes of esophageal ulceration and the high response rate to oral corticosteroid therapy, all HIV infected patients with esophageal ulceration should undergo endoscopy with biopsy to obtain a definitive diagnosis. We review the literature about the etiology, pathogenesis, management and treatment of the IEU.
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Affiliation(s)
- F García Durán
- Servicio de Aparato Digestivo, Hospital General Gregorio Marañón, Madrid
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