Interferon Therapy For Hepatitis C And Its Impact On Glomerular Filtration Function

Background and aims:Entry of Hepatitis C Virus into human body, is known to cause different degrees of kidney injury. As far as we know, the treatment and prognosis of kidney disease is closely related to the treatment and prognosis of HCV infection. Fuyu region of Jilin Province has a high incidence of HCV infection, therefore we took people in this area as subjects of our study. Our study aimed to explore whether or not the interferon alpha-2b plus ribavirin antiviral treatment can improve renal function in patients with chronic hepatitis C.Subjects:Our subjects contained patients who participated in the epidemiological investigation of our research center in September2012, and participated in our follow-up interview in September2014. We investigated people from Desheng town, Gongpengzi town, Dalinzi town, New Wanfa town, Gengxin village of Fuyu region of Jilin Province. After ruling out subjects with diabetes and hepatitis B,404subjects were included,106subjects were involved in the interferon alpha-2b plus ribavirin anti HCV treatment.HCV infection was defined as HCV antibody positive, antiviral treatment referred to interferon alpha-2b (5million IU,3times per week, subcutaneous injection) plus ribavirin (15mg/kg/day, oral)48weeks. According to whether or not accepted the antiviral treatment, our subjects were divided into:unattended with HCV RNA positive group, spontaneous clearance group, treatment cured group and treatment uncured group.Methods:With signed informed consent, we collected information in the form of questionnaire which included basic information including history of related diseases, diagnosis and treatment process of hepatitis C, smoking history, drinking history, whether shared syringe needles, family history of relevant epidemiological data, etc. We collected fasting venous blood collection to test the virological and biochemical indicators, mainly include:liver function test, blood routine, renal function test, blood lipid profile, blood glucose, urine routine and HCV quantification. We collected imaging data in the form of FibroScan.We calculated eGFR through Cockcroft-Gault, defined proteinuria as ACR more than3mg/mmol. Through analyzing the basic information, kidney function tests and its related indicators to explore the correlation of HCV antiviral treatment with kidney disease.Results:Our research included404subjects,242men (59.9%) and161(39.9%) women, average age was55.55years±8.1years, basic information of different groups showed that:unattended with HCV RNA positive group included212people (52.5%), spontaneous clearance group included86people (21.3%), treatment cured group included48people (11.9%), treatment uncured group included58people(14.4%).ALT, AST, ALP, GGT, TB were all statistically significant different among different groups (p<0.05), spontaneous clearance group and treatment cured group were higher than that of unattended with HCV RNA positive group and treatment uncured group. CHE and PLT were all significantly different between different groups (p<0.05), spontaneous clearance group and treatment cured group were lower than that of unattended with HCV RNA positive group and treatment uncured group. Proteinuria positive rate in ascending order was observed in as follows:treatment cured group, treatment uncured group, spontaneous clearance group, unattended with HCV RNA positive group. Antiviral treatment can improve the research subjects’eGFR, creatinine and urea nitrogen, while as to ACR classification, albuminuria and cystatin C there were no significant differences. HCV genotype, HCV RNA loads for the year2012and HCV RNA changes for the years between2012and2014had no significant correlation with the progress of eGFR. Whether or not our subjects achieve the targeted RVR or SVR, eGFR improved with the antiviral treatment.Conclusions:(1)The clearance of HCV RNA improved liver function and degree of liver cirrhosis.(2) Antiviral treatment can improve the research subjects’eGFR, creatinine and urea nitrogen, while as to ACR classification, albuminuria and cystatin C there were no significant differences.(3) HCV genotype, HCV RNA loads for the year2012and HCV RNA changes for the years between2012and2014had no significant correlation with the progress of eGFR.(4) We should stick to48weeks’complete antiviral treatment, even if the HCV RNA quantification did not reduce to undetectable level after antiviral therapy for24weeks, in order to improve kidney function.Research significance:Researches have shown that the treatment of HCV related kidney disease is dependent on a standard polyethylene glycol interferon combine ribavirin antiretroviral treatment [1-3], whether should we still stick to48weeks’ complete antiviral treatment, even if the HCV quantification did not reduce to undetectable level after antiviral therapy for24weeks, in order to improve kidney function.