Abstract: PUB587
Efficacy and Safety of Sofosbuvir Plus Simeprevir as Therapy for HCV-Associated Glomerulonephritis: Report of Two Cases
Session Information
Category: Trainee Case Report
- 1203 Glomerular Diseases: Clinical, Outcomes, and Trials
Authors
- Arruda, Raissa Melo, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil
- Batista, Andrea Doria, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil
- Filgueira, Norma A., Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil
- De moura, Izolda Maria fernandes, Universidade Federal de Pernambuco, Jaboatão dos Guararapes, Brazil
- Sette, Luis H.B.C., Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil
- Lopes, Edmundo Pessoa, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil
Introduction
HCV patients with glomerulopathies were treated, initially, peg-interferon (PEG-IFN) associated with ribavarin (RBV), but this therapy have been induced serious side effects and low sustained virologic response (SVR). The new direct-acting antivirals (DAAs) treatment are been considered revolutionary antiviral therapy, leading to infection cure in more than 90% of patients. Since 2016 new reports have emerged using DAAs in HCV-associated glomerulopathies but there are still few reports.
Case Description
Patient 1 - male, 41 year-old, with diagnosis of chronic HCV infection associated with glomerulopathy admited in 2016 with nephrotic syndrome with anti-HCV and HCV-RNA positive (viral load of 2,064,684 UI/mL and log 6). He was treated with SOF (400 mg/day) plus SIM (150 mg/day) for 12 weeks, evolving with normalization of aminotransferases normalizations and HCV-RNA negativity at the end of treatment and after 12 weeks (SVR), cryoglobulinemia negativity and significant proteinuria reduction.
Patient 2 – male, 50 year-old, was diagnosed 24 years ago with HCV infection prior to blood donating. He lost outpatient follow-up and returned in 2005, when genotype 1b infection was identified. He had no response to PEG-IFN plus RBV and in 2014, he presented with thrombocytopenia, nephrotic syndrome, C3 and C4 consumption, cryoglobulinemia positive. In 2016, he was treated with SOF plus SIM for 12 weeks, evolving with transaminases normalization, HCV-RNA negativity at the end of treatment and after 12 weeks, cryoglobulinemia negativity and significant reduction of proteinuria.
Baseline and after treatment examens shown in Table.
Discussion
This report describes two cases of HCV related Glomerulopathy with cryoglobulinemia treated with SOF plus SIM therapy showing no significant side effects and improvement hepatic and renal diseases.
Clinical and Laboratory Characteristics of Patientes Before and After Treatment with Sofosbuvir plus Simeprevir
| Patiente 1 | Patiente2 | |||
| Viral Load (UI/mL)(log 6) | 2,064,684 | Negative | 1,193,977 | Negative |
| Proteinuria (g/24h) | 6.4 | 0.12 | 4.33 | 0.26 |
| Creatinine (mg/dL) | 1.1 | 1.2 | 1.6 | 1.3 |
| AST/ALT (mg/dL) | 40,5/50,8 | 26/22 | 115/84 | 26/26 |