Effect of antiviral therapy on hepatitis C virus related glomerulopathy

• Published in: Saudi journal of kidney diseases and transplantation Vol. 19; no. 5; pp. 775 - 780
• Main Authors: Abbas, Ghulam, Husayn, Shahid, Shafi, Tahir
• Format: Journal Article
• Language: English
• Published: Riyadh, Saudi Arabia Saudi Center for Organ Transplantation 01.09.2008; Medknow Publications and Media Pvt. Ltd; Wolters Kluwer Medknow Publications
• Subjects: Antibody Formation; Antiviral Agents - adverse effects; Antiviral Agents - therapeutic use; Aspartate Aminotransferases - blood; Biological response modifiers; Care and treatment; Creatinine - blood; Glomerulonephritis - drug therapy; Glomerulonephritis - virology; Glomerulonephritis, Membranoproliferative - drug therapy; Glomerulonephritis, Membranoproliferative - virology; Glomerulonephritis, Membranous - drug therapy; Glomerulonephritis, Membranous - virology; glomerulopathy; HCV nephropathy; Hepacivirus - genetics; Hepatitis C; Hepatitis C - complications; Hepatitis C - drug therapy; Hepatitis C - immunology; Hepatitis C virus; Humans; Interferon; Interferon alpha; Interferons - adverse effects; Interferons - therapeutic use; membranoproliferative glomerulonephritis; Proteinuria - etiology; Ribavirin; Ribavirin - adverse effects; Ribavirin - therapeutic use; RNA, Viral - genetics; الأميد; التهاب الكبد سي; التهاب كبيبات الكلى; الفيروسات; المرضى; المواد المضادة للفيروسات
• ISSN: 1319-2442; 2320-3838

To determine the efficacy of antiviral therapy in hepatitis C virus associated glome­rulopathy, we studied 30 patients with HCV-associated glomerulopathy at Sheikh Zayed Hospital, Lahore, Pakistan from June 2004 to February 2007. Membranoproliferative glomerulonephritis (MPGN) was the commonest kidney lesion, being reported in 25 / 30 (83%), followed by membra­nous glomerulonephritis (MGN) in 3 / 30 (10%) and mesangioproliferative glomerulonephritis (MesGN) in 2 / 30 (7%). Cryoglobulinaemia was positive in 8 / 20 (40%) cases. Most common HCV genotype was 3a. All the patients received interferon alpha combined with ribavirin therapy for 6-12 months based on viral genotypes and doses were adjusted according to renal function. Anti-viral response was achieved in the form of aviremia at completion of 6 months treatment in 8 / 30 (26.6%), decreased transaminases levels from a mean of 96.4 ± 72.2 to 60.1 ± 44.3 IU / L, p= 0.005, 24-hour proteinuria decreased significantly from a mean of 4.8 g to 1.20 g, p= 0.001, and complement C3 and C4 concentrations returned to normal in those subjects who responded to treatment. The rate of relapse was 50%. We conclude that though the overall antiviral response of HCV was not high, there was a significant reduction in proteinuria suggesting indirectly an improvement in renal patho­logy. Further studies with large number of patients with follow-up renal biopsies are warranted.