The impact of HCV eradication using interferon-free direct acting antivirals on bone-mineral, anemia parameters and peripheral insulin resistance in hepatitis c-infected Egyptian hemodialysis cohort

Theodor Bilharz Research Institute

Bibliographic Information

Authors: Elnokeety M.M.; Darwish R.A.; Hegazy M.T.; Abouzeid S.; Fayed A.

Journal: Renal Replacement Therapy

Publisher: BioMed Central Ltd

Publication Date: 1 October 2023

Volume / Issue: Volume 9 / Issue 1

Article No.: 49

ISSN: 20591381

DOI: 10.1186/s41100-023-00500-4

Scopus: View on Scopus

Document Type: Article

Access: All Open Access; Gold Open Access; Green Open Access

Authors and Affiliations

Elnokeety M.M., Nephrology Unit, Department of Internal Medicine, Faculty of Medicine, Cairo University, Al-Saray St., El-Maniel, Cairo, 11562, Egypt; Darwish R.A., Nephrology Unit, Department of Internal Medicine, Faculty of Medicine, Cairo University, Al-Saray St., El-Maniel, Cairo, 11562, Egypt; Hegazy M.T., Rheumatology and Clinical Immunology Unit, Department of Internal Medicine, Faculty of Medicine, Cairo University, Al-Saray St., El-Maniel, Cairo, 11562, Egypt, Rheumatology and Clinical Immunology Unit, Department of Internal Medicine, Faculty of Medicine, New Giza University (NGU), Giza, Egypt; Abouzeid S., Nephrology Department, Theodor Bilharz Research Institute, Cairo, Egypt; Fayed A., Nephrology Unit, Department of Internal Medicine, Faculty of Medicine, Cairo University, Al-Saray St., El-Maniel, Cairo, 11562, Egypt

Abstract

Background: Hepatitis C virus (HCV) infection is linked to a higher mortality rate in hemodialysis (HD) patients. We aimed to see if HCV eradication using interferon-free direct acting antivirals (DAAs) can affect bone-mineral and anemia biochemical parameters such as serum calcium (Ca++), phosphorus (PO4+), parathormone (PTH), fibroblast growth factor 23 (FGF23), hemoglobin (HB), and ferritin in HD patients and also peripheral insulin resistance by monitoring serum fasting insulin and HOMA insulin resistance (HOMA-IR). Methods: Three hundred and thirty-four adults on regular HD with positive HCV genotype 4 (191 male and 143 female) were included; 157 of them had seroconversion during HD. All were hepatitis B virus (HBV) negative and received treatment with DAAs. All cases were examined for body mass index (BMI), HB, ferritin level, transferrin saturation (TSAT), Ca++, PO4+, PTH, FGF23, serum albumin, alanine transaminase (ALT), fasting insulin level, and HOMA-IR at the beginning and then were measured after 6 and 12 months from a sustained virological response (SVR). Results: After 6 and 12 months from SVR, there was a significant increase in serum Ca despite no change in oral calcium dose requirement over that period (p = 0001), a significant increase in HB, serum iron (p = 0001), and a significant reduction in serum ferritin, PO4, PTH, and FGF23 (p = 0001). Both fasting insulin level and HOMA-IR were statistically significantly dropped. Conclusion: HCV eradication with interferon-free DAAs showed a statistically significant impact on hemodialysis patients regarding hemoglobin, ferritin level, bone-mineral parameters, and improvement in peripheral insulin resistance. © 2023, The Japanese Society for Dialysis Therapy and BioMed Central Ltd.

Keywords

DAAs; FGF23; HCV; Hemodialysis; Insulin resistance; Parathormone

Citation Information

Scopus Citations: 2

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