{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T11:02:18Z","timestamp":1792839738236,"version":"4.5.0"},"reference-count":43,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2022,11,20]],"date-time":"2022-11-20T00:00:00Z","timestamp":1668902400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>Background: Hepatitis C virus (HCV) is still common in patients with chronic kidney disease. It has been recently discovered that chronic HCV is a risk factor for increased incidence of CKD in the adult general population. According to a systematic review with a meta-analysis of clinical studies, pooling results of longitudinal studies (n = 2,299,134 unique patients) demonstrated an association between positive anti-HCV serologic status and increased incidence of CKD; the summary estimate for adjusted HR across the surveys was 1.54 (95% CI, 1.26; 1.87), (p &lt; 0.0001). The introduction of direct-acting antiviral drugs (DAAs) has caused a paradigm shift in the management of HCV infection; recent guidelines recommend pan-genotypic drugs (i.e., drugs effective on all HCV genotypes) as the first-choice therapy for HCV, and these promise to be effective and safe even in the context of chronic kidney disease. Aim: The purpose of this narrative review is to show the most important data on pan-genotypic DAAs in advanced CKD (CKD stage 4\/5). Methods: We recruited studies by electronic databases and grey literature. Numerous key-words (\u2018Hepatitis C\u2019 AND \u2018Chronic kidney disease\u2019 AND \u2018Pan-genotypic agents\u2019, among others) were adopted. Results: The most important pan-genotypic combinations for HCV in advanced CKD are glecaprevir\/pibrentasvir (GLE\/PIB) and sofosbuvir\/velpatasvir (SOF\/VEL). Two clinical trials (EXPEDITION-4 and EXPEDITION-5) and some \u2018real-world\u2019 studies (n = 6) reported that GLE\/PIB combinations in CKD stage 4\/5 gave SVR12 rates ranging between 86 and 99%. We retrieved clinical trials (n = 1) and \u2018real life\u2019 studies (n = 6) showing the performance of SOF\/VEL; according to our pooled analysis, the summary estimate of SVR rate was 100% in studies adopting SOF\/VEL antiviral combinations. The drop-out rate (due to AEs) in patients on SOF\/VEL ranged between 0 and 4.8%. Conclusions: Pan-genotypic combinations, such as GLE\/PIB and SOF\/VEL, appear effective and safe for HCV in advanced CKD, even if a limited number of studies with small sample sizes currently exist on this issue. Studies are under way to assess whether successful antiviral therapy with DAAs will translate into better survival in patients with advanced CKD.<\/jats:p>","DOI":"10.3390\/v14112570","type":"journal-article","created":{"date-parts":[[2022,11,21]],"date-time":"2022-11-21T03:11:21Z","timestamp":1669000281000},"page":"2570","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Recent Information on Pan-Genotypic Direct-Acting Antiviral Agents for HCV in Chronic Kidney Disease"],"prefix":"10.3390","volume":"14","author":[{"given":"Fabrizio","family":"Fabrizi","sequence":"first","affiliation":[{"name":"Division of Nephrology, Dialysis, and Kidney Transplant, Foundation IRCCS C\u00e0 Granda Ospedale Maggiore Policlinico, 20122 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Tripodi","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Dialysis, and Kidney Transplant, Foundation IRCCS C\u00e0 Granda Ospedale Maggiore Policlinico, 20122 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta","family":"Cerutti","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Dialysis, and Kidney Transplant, Foundation IRCCS C\u00e0 Granda Ospedale Maggiore Policlinico, 20122 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1749-7100","authenticated-orcid":false,"given":"Luca","family":"Nardelli","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Dialysis, and Kidney Transplant, Foundation IRCCS C\u00e0 Granda Ospedale Maggiore Policlinico, 20122 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo M.","family":"Alfieri","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Dialysis, and Kidney Transplant, Foundation IRCCS C\u00e0 Granda Ospedale Maggiore Policlinico, 20122 Milano, Italy"},{"name":"Department of Clinical Sciences and Community Health, University School of Medicine, 20122 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria F.","family":"Donato","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Foundation IRCCS C\u00e0 Granda Ospedale Maggiore Policlinico, 20122 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Castellano","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Dialysis, and Kidney Transplant, Foundation IRCCS C\u00e0 Granda Ospedale Maggiore Policlinico, 20122 Milano, Italy"},{"name":"Department of Clinical Sciences and Community Health, University School of Medicine, 20122 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,11,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Fabrizi, F., Cerutti, R., and Messa, P. 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