Clinicopathological Analysis and Therapy in Hepatitis C Virus-Associated Nephropathy

• Published in: Internal Medicine Vol. 35; no. 7; pp. 529 - 533
• Main Authors: KOMATSUDA, Atsushi, IMAI, Hirokazu, WAKUI, Hideki, HAMAI, Keiko, OHTANI, Hiroshi, KODAMA, Takahito, OYAMA, Yuhta, MIURA, Akira B., NAKAMOTO, Yasushi
• Format: Journal Article
• Language: English
• Published: Tokyo The Japanese Society of Internal Medicine 1996; Japanese Society of Internal Medicine
• Subjects: Adolescent; Adult; Aged; Biological and medical sciences; Female; Genotype; Glomerulonephritis, IGA - diagnosis; Glomerulonephritis, IGA - etiology; Glomerulonephritis, IGA - therapy; Glomerulonephritis, Membranoproliferative - diagnosis; Glomerulonephritis, Membranoproliferative - etiology; Glomerulonephritis, Membranoproliferative - therapy; Glomerulonephritis, Membranous - diagnosis; Glomerulonephritis, Membranous - etiology; Glomerulonephritis, Membranous - therapy; HCV genotype; Hepacivirus - genetics; Hepatitis C - complications; Hepatitis C - diagnosis; Hepatitis C - therapy; hepatitis C virus (HCV) infection; Human viral diseases; Humans; IgA nephropathy; Infectious diseases; Interferon-alpha - therapeutic use; Kidney Diseases - diagnosis; Kidney Diseases - etiology; Kidney Diseases - therapy; Male; Medical sciences; membranoproliferative glomerulonephritis (MPGN); membranous nephropathy (MN); Middle Aged; RNA, Viral - blood; RNA, Viral - genetics; Steroids - therapeutic use; treatment; Viral diseases; Viral hepatitis; Kidney disease; Human; Corticosteroid; Urinary system disease; Alpha interferon; Hepatic disease; Genotype; Infection; Symptomatology; Chemotherapy; Association; Treatment; Viral disease; Digestive diseases; Membranous glomerulonephritis; Mesangial proliferative glomerulonephritis; Viral hepatitis C
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.35.529

We analyzed the Clinicopathological features and therapy in 19 patients with kidney disease accompanied by hepatitis C viral infection, including 12 patients with mesangial proliferative glomerulonephritis (including eight with IgA nephropathy), six with membranoproliferative glomerulonephritis (MPGN), and one with membranous nephropathy. Persistent hematuria and/or proteinuria (10 patients) was the most common finding, followed by nephrotic syndrome (8 patients). Cryoglobulinemia was detected in six of 19 patients examined (four of six patients with MPGN). Analysis of hepatitis C virus (HCV)-RNA genotype in 13 patients revealed that nine of them had type II genotype. All four patients with MPGN, who had serum positive for HCV-RNA, had type II genotype. Five patients were treated with interferon-α (IFN-α) without a demonstrable effect on renal impairment, whereas five of 11 patients treated with steroids showed improvement of the renal impairment. During the course of steroid therapy, the serum titer of HCV-RNA decreased in 5 of 7 patients. These observations suggest that HCV infection may be associated with several forms of glomerulonephritis. Type IIHG V-RNA may have a strong association with MPGN in Japan. Steroid therapy is not contraindicated in patients with HCV-associated nephropathy if they are resistant to IFN-α treatment. (Internal Medicine 35:529-533, 1996)