Final answer:
For a patient with an eGFR less than 30ml/min, Mavyret (glecaprevir/pibrentasvir) may be a suitable antiviral for the treatment of chronic hepatitis C across all genotypes, taking into consideration renal impairment and avoiding potential drug toxicity.
Step-by-step explanation:
For a patient with an eGFR <30ml/min seeking treatment for chronic hepatitis C infection, careful consideration must be given to the choice of medication, as kidney function can significantly influence drug clearance and potential toxicity. The use of antivirals like sofosbuvir in combination with ribavirin and/or peginterferon alfa has shown effectiveness in treating hepatitis C virus (HCV) genotypes. It should be noted that sofosbuvir is a nucleotide polymerase inhibitor that hinders the synthesis of viral RNA, but its use in patients with renal impairment must be assessed on an individual basis. Additionally, protease inhibitors such as simeprevir, used in conjunction therapy with ribavirin and interferon, target the protease involved in hepatitis C virus replication. Mavyret (glecaprevir/pibrentasvir) has been used to treat chronic hepatitis C across all genotypes and may be a suitable option for patients with renal impairment, including those with severe kidney disease.