Effect of Direct AntiViral Drugs of Chronic HCV on eGFR in Assuit Universiry Hospital
Effect of Direct AntiViral Drugs of Chronic HCV on eGFR in Assuit Universiry Hospital
1. evaluation of glomerular filtration rate(eGFR)changes during HCV treatment with direct
 antiviral drugs according to 2018 guideline.

 2. TO estimate the frequency of renal impairment by direct antiviral drugs By detection of
 any changes in e GFR.

 3. Assessment The Renal safety during HCV treatment with direct antiviral drugs according
 to 2018 guideline.

 4. To clarify the importance of laboratory and other modalities in detection and estimation
 of frequency of renal impairment by direct antiviral drugs according to 2018 guideline.
Hepatitis C virus (HCV) has an estimated global prevalence of 2%-3% with 130-170 million
 people infected with HCV.(1) HCVcauses chronic inflammation of the liver leading to chronic
 hepatitis, which can advance to liver cirrhosis and hepatocellular carcinoma and significant
 extrahepatic complications.(2) Additionally, HCV has been shown to have a significant
 negative effect on apatient's overall quality of life, including decreased work hours and
 productivity and increased healthcare costs.(3) Cirrhosis and hepatocellular carcinoma
 related to HCV infection represent the most common indications for liver transplantation duo
 to poor treatment options.(4) Until recently, interferon-based treatments were thebackbone of
 HCV treatment options.(5) Unfortunately,therapy was only modestly effective and
 associatedwith significant side effects.(6) Therefore, research has focused on HCV
 eradication using oral antiviral therapy.

 Recent clinical studies have demonstrated efficacy using the nucleotide analogue inhibitor
 sofosbuvir(Sovaldi; Gilead Sciences, Inc., Foster City, CA) as the backbone in treatment of
 non transplant and post transplant recurrent HCV.(7) Both the ION-1 and ION-2 trials
 demonstrated nearly 99% efficacy in the treatment ofnontransplant, noncirrhotic HCV
 patientsusing sofosbuvir in a fixed-dose combination with theNS5A inhibitor ledipasvir
 (Harvoni, Gilead Sciences,Inc.), both with and without ribavirin.(8,9) The side effect
 profile of ledipasvir/sofosbuvir (LDV/SOF) hasbeen relatively mild and the drug has been well
 tolerated in trials, especially compared with previous interferon-based regimens.

 The ION trials report that LDV/SOF therapy was primarily complicated by headaches or fatigue
 inapproximately 10% of patients. Less frequently, patients experienced rashes, nausea,
 diarrhea, and insomnia.Serious side effects, such as nephrotoxicity, were not demonstrated by
 the ION-1 and ION-2 trials; however, these trials were conducted in a controlled clinical
 setting with rigorous exclusion criteria. Such trials are not always entirely reflective of
 the general patient population. Early data suggest possible risk of renal impairment during
 treatment with the use of direct antiviral drugs(10) this study is about renal safety and
 changes in eGFR in patients with chronic HCV undergoing direct acting antiviral therapy
 according to 2018 guideline.
Inclusion Criteria:

 -  chronic hepatitis C virus patients will be on direct antiviral therapy .

 Exclusion Criteria:

 -  patients with DM ,HTN ,CKD,Autoimmune Diseases Patients with kidney injury other than
 DAAs Patients with sever heart failure or malignancy