Effects of pegylated interferon α-2a on hepatitis-C-virus-associated glomerulonephritis

Abstract

Hepatitis C virus (HCV) infection leads to chronic liver disease, but it has also been associated with extrahepatic manifestations. Membranoproliferative glomerulonephritis (MPGN) is the most common renal disease associated with HCV. Although renal disease related to HCV in adults has been well studied, it has not been well studied in children because it is rare. A recent study found that antiviral therapy was effective for adult patients with HCV-associated MPGN. We report a 9-year-old girl with HCV-associated MPGN. Her HCV genotype was 1b, and her virus load was high. The first renal biopsy showed mesangial proliferation and partial double contours of the basement membrane on light microscopy and immunofluorescence staining with immunoglobulin (Ig) M, IgG, and C3. The patient was successfully treated with pegylated interferon (IFN) alpha-2a monotherapy. The antiviral therapy was generally well tolerated. After antiviral therapy, a sustained virological response-defined as negative HCV ribonucleic acid (RNA) at least 24 weeks after antiviral treatment-was achieved, the proteinuria disappeared, and the second renal biopsy showed improvement.

Efficacy of pegylated interferon‐α2a monotherapy in Japanese children with chronic hepatitis C

“…These diseases were in remission or stable at the time of PEG IFN therapy, except membranoproliferative glomerulonephritis. This case was successfully treated with PEG IFN therapy and her renal condition was improved 12 . All patients were naïve cases with respect to IFN therapy.…”

“…In one patient with genotype 2, ALT levels exceeded 500 IU/L and the therapy was stopped at week 12. The ALT titers returned to normal after cessation of therapy and SVR was achieved 12 …”

Hepatitis C virus infection in children and adolescents

“…Similar manifestations, while described, are less prevalent in children with HCV infection. For example, membranoproliferative glomerulonephritis, the most common renal disease associated with HCV infection in adults,49 has been reported in only three children 50, 51, 52. Thyroid dysfunction and thyroid autoimmune disease is rare, but thyroid‐specific antibodies, subclinical hypothyroidism, and autoimmune thyroiditis have been described in children 53, 54, 55.…”

Autoimmunity and Extrahepatic Manifestations in Treatment-Naïve Children with Chronic Hepatitis C Virus Infection

“…To the best of our knowledge only three cases of HCV-associated membranoproliferative glomerulonephritis in children have been reported [16–18]. The specific pathogenesis of the glomerular injury caused by HCV infection is not known, but it is thought to result from the deposition of circulating immune complexes of HCV and anti-HCV on the glomerular capillary in the mesangium [2].…”

“…The specific pathogenesis of the glomerular injury caused by HCV infection is not known, but it is thought to result from the deposition of circulating immune complexes of HCV and anti-HCV on the glomerular capillary in the mesangium [2]. In one of the three children described, successful antiviral monotherapy with pegylated interferon- α resulted in HCV RNA clearance and disappearance of proteinuria [16]. …”