Effect of conversion from calcineurin inhibitors to everolimus on hepatitis C viremia in adult kidney transplant recipients

• Published in: Brazilian Journal of Nephrology Vol. 40; no. 2; pp. 143 - 150
• Main Authors: Pacheco, Larissa Sgaria, Garcia, Valter Duro, Prá, Ronivan Luis Dal, Cardoso, Bruna Doleys, Rodrigues, Mariana Ferras, Zanetti, Helen Kris, Meinerz, Gisele, Neumann, Jorge, Gnatta, Diego, Keitel, Elizete
• Format: Journal Article
• Language: English
• Published: Brazil Sociedade Brasileira de Nefrologia 01-04-2018
• Subjects: Adult; Calcineurin Inhibitors - therapeutic use; Carga Viral; Everolimus - therapeutic use; Female; Hepatite C; Hepatitis C, Chronic - drug therapy; Humans; Immunosuppressive Agents - therapeutic use; Imunossupressão; Kidney Transplantation; Male; Original; Postoperative Complications - drug therapy; Postoperative Complications - virology; Prospective Studies; Transplante Renal; Viremia - drug therapy
• ISSN: 0101-2800; 2175-8239; 2175-8239
• DOI: 10.1590/2175-8239-JBN-3860

Currently, there is no specific immunosuppressive protocol for hepatitis C (HCV)-positive renal transplants recipients. Thus, the aim of this study was to evaluate the conversion effect to everolimus (EVR) on HCV in adult kidney recipients.
This is an exploratory single-center, prospective, randomized, open label controlled trial with renal allograft recipients with HCV-positive serology. Participants were randomized for conversion to EVR or maintenance of calcineurin inhibitors.
Thirty patients were randomized and 28 were followed-up for 12 months (conversion group, Group 1 =15 and control group, Group 2 =13). RT-PCR HCV levels reported in log values were comparable in both groups and among patients in the same group. The statistical analysis showed no interaction effect between time and group (p value G*M= 0.852), overtime intra-groups (p-value M=0.889) and between group (p-value G=0.286). Group 1 showed a higher incidence of dyslipidemia (p=0.03) and proteinuria events (p=0.01), while no difference was observed in the incidence of anemia (p=0.17), new onset of post-transplant diabetes mellitus (p=1.00) or urinary tract infection (p=0.60). The mean eGFR was similar in both groups.
Our study did not show viral load decrease after conversion to EVR with maintenance of antiproliferative therapy.