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Hepatitis C in CKD — SCE Infectious Diseases MCQ

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ModerateHepatitisHepatitis C in CKDSCE Infectious Diseases

A 48-year-old man is diagnosed with hepatitis C (genotype 2, treatment-naive, no cirrhosis). His eGFR is 22 mL/min/1.73 m² (CKD stage 4). Which DAA regimen is most appropriate?

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Correct answer: A — Glecaprevir/Pibrentasvir for 8 weeks — no dose adjustment needed for severe renal impairment

Glecaprevir/Pibrentasvir is the preferred DAA regimen for patients with severe renal impairment (eGFR <30) as it does not require dose adjustment. Neither Glecaprevir nor Pibrentasvir undergoes significant renal elimination. Sofosbuvir-based regimens are not recommended in severe renal impairment (eGFR <30) due to accumulation of the renally cleared metabolite GS-331007. The regimen is given for 8 weeks for treatment-naive, non-cirrhotic GT2 patients.

Reference: NICE TA587 2019 – Glecaprevir/Pibrentasvir; EASL 2024 – HCV in CKD