Paritaprevir/Ritonavir, Ombitasvir, Dasabuvir or Glecaprevir/Pibrentasvir for Advanced CKD Patients with HCV Genotype 1: Impact on Kidney Function and Cardiovascular Disease Risk

This study focuses on adults with advanced chronic kidney disease (CKD) who have an estimated glomerular filtration rate (eGFR) less than 45ml/min and are infected with hepatitis C virus (HCV) genotype 1. The main goal is to evaluate the safety and effectiveness of two treatment regimens: Viekira Pak (paritaprevir/ritonavir, ombitasvir, dasabuvir) ± ribavirin or Mavyret (Glecaprevir / Pibrentasvir). The study also aims to understand how these treatments affect traditional and novel markers of kidney function and cardiovascular disease risk in patients with advanced CKD. The potential outcomes of this study could lead to improved care for patients with HCV and advanced CKD, addressing a significant unmet need in this population. During this study, participants will receive either the Viekira Pak or Mavyret regimen. The study will measure accepted markers of kidney function and novel biomarkers of CKD progression to determine if they improve with the eradication of HCV. The primary outcomes include measuring the average change in various plasma and urine biomarkers from baseline to post-treatment. These biomarkers include Interferon Gamma-induced Protein 10 (IP-10), Interferon (IFN)-Gamma, Interleukin (IL)-6, Tumor Necrosis Factor (TNF)-Alpha, among others. The changes in these biomarkers will be calculated by finding the difference between baseline values and the average of 12-weeks post-treatment and 40-weeks post-treatment for each patient.