Membranoproliferative Glomerulonephritis Associated with Hepatitis C Virus Infection

Johnson, Richard J.; Gretch, David R.; Yamabe, Hideaki; Hart, Jaime; Bacchi, Carlos E.; Hartwell, Peter; Couser, William G.; Corey, Lawrence; Wener, Mark H.; Alpers, Charles E.; Willson, Richard A.

doi:10.1056/nejm199302183280703

Cited by 820 publications

(298 citation statements)

References 28 publications

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“…This hypothesis was generated based on observations that hepatitis C is associated with some forms of glomerular disease [7][8][9][10][11] , that the co-existence of hepatitis C appears to increase the progression of CKD 14 , that viral particles or antigenicity is found in glomeruli and tubules of kidney biopsies 16,17 , and that CKD is very prevalent in areas with particularly high rates of hepatitis C infection 22 . Our results demonstrated no increased risk of having or developing CKD in patients who are hepatitis C positive in cross-sectional and longitudinal analyses after controlling for multiple other known risk factors for CKD.…”

Section: Discussionmentioning

confidence: 99%

Association of Hepatitis C Virus Infection With Prevalence and Development of Kidney Disease

Moe

Pampalone

Ofner

et al. 2008

American Journal of Kidney Diseases

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Section: Discussionmentioning

confidence: 99%

Association of Hepatitis C Virus Infection With Prevalence and Development of Kidney Disease

Moe

Pampalone

Ofner

et al. 2008

American Journal of Kidney Diseases

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“…11 In the setting of OLT, this secondary effect may add to a variety of glomerulopathies associated with liver diseases, such as mesangial glomerulonephritis in alcoholic cirrhosis 12 and membranoproliferative glomerulonephritis in hepatitis C virus infection. 13 The pathogenesis of cyclosporine nephrotoxicity appears related to renal vasoconstriction and further development of renal arteriolar hyalinosis and glomerular sclerosis, even in the absence of early increases in serum creatinine level. These histological changes become more severe as the dose and time of cyclosporine treatment increase.…”

Section: Discussionmentioning

confidence: 99%

Conversion of liver transplant recipients on cyclosporine with renal impairment to mycophenolate mofetil

et al. 1999

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The management of liver transplant recipients with renal function impairment remains controversial because cyclosporine withdrawal from triple immunosuppression regimens may be followed by graft rejection. A nonnephrotoxic and powerful immunosuppressant such as mycophenolate mofetil (MMF) could allow a reduction of cyclosporine dosage or its withdrawal and an improvement in renal function in these patients. Eleven patients with serum creatinine levels greater than 1.5 mg/dL, normal graft function, and a rejection-free period of at least 1 year started MMF at a dose of 2000 mg/d (reduced in case of adverse events) while cyclosporine dosage was slowly reduced. At last follow-up (63 ؎ 5 weeks), 7 patients remained free of cyclosporine (6 of those patients are also free of steroids), 2 patients reduced their cyclosporine dose, and 2 patients developed mild acute rejection that responded to a switch to tacrolimus therapy. Serum creatinine and urea levels in the 7 patients free of cyclosporine decreased from 2.22 ؎ 0.13 to 1.90 ؎ 0.19 mg/dL (P ‫؍‬ .05) and 0.95 ؎ 0.10 to 0.60 ؎ 0.10 g/L (P F .001), respectively. Creatinine clearance increased from 38.16 ؎ 5.60 to 47.01 ؎ 6.76 mL/min (P ‫؍‬ .005). Control of arterial hypertension also improved. Tolerance to MMF was good, but 6 patients required dose reductions, mainly because of asymptomatic anemia. In conclusion, in liver transplant recipients with stable graft function, MMF may allow cyclosporine dose reduction or discontinuation, thus improving renal function and the control of arterial hypertension. This change of treatment must be carefully monitored because of the frequent need for MMF dose reduction and the risk for rejection.

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“…While mixed cryoglobulins have been described in 50% of patients with chronic HCV infection (l), 53-82% of patients with mixed cryoglobulinemia had chronic HCV infection, and this virus is now considered to be an etiologic agent for mixed cryoglobulinemia (2)(3)(4). Latent autoimmune thyroid disease, glomerulonephritis, polymyositis, and pulmonary fibrosis have been reported in association with HCV (5)(6)(7)(8). Lymphocytic sialadenitis has been reported in patients with chronic HCV infection, but the clinical and immunologic status of those patients was not described (9).…”

mentioning

confidence: 99%

Sicca syndrome associated with hepatitis C virus infection

Jørgensen

Legouffe

Perney

et al. 1996

Arthritis & Rheumatism

135

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Objective. To determine the prevalence of hepatitis C virus (HCV) infection in patients with sicca syndrome, and to determine the clinical, immunologic, and genetic characteristics of sicca syndrome associated with HCV.Methods. We conducted a prospective study in a university hospital immunology-rheumatology department. Sixty-two consecutive patients with sicca syndrome according to the European criteria for Sjogren's syndrome were included. HCV infection was diagnosed in patients with positive recombinant immunoblot assay findings and the presence of viral RNA in serum and saliva. Rheumatoid factor (RF), cryoglobulins, antinuclear antibodies, and anti-SS-NSS-B antibodies were sought. HLA typing was performed on all patients.Results. The prevalence of HCV infection in patients with sicca syndrome was 19%. The incidence of neurologic involvement was significantly increased in patients with sicca syndrome associated with HCV infection (24% versus 4%; P c 0.03), as was elevations in transaminase levels (87.5% versus 16%; P < 0.0001). RF and cryoglobulins were more frequent in HCV-positive sicca syndrome patients (62% versus 30%; P C 0.03, and 56% versus 10%; P c 0.001, respectively). In contrast, anti-SS-NSS-B antibodies were present in 38% of HCVnegative sicca syndrome patients, but in only 1 HCVpositive sicca syndrome patient (P c 0.01). No significant difference in HLA type was observed. Viral RNA

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Membranoproliferative Glomerulonephritis Associated with Hepatitis C Virus Infection

Abstract: Chronic HCV infection is associated with cryoglobulinemia and membranoproliferative glomerulonephritis. The pathogenesis is unknown, but may relate to deposition within glomeruli of immune complexes containing HCV, anti-HCV IgG, and IgM rheumatoid factors.

Cited by 820 publications

References 28 publications

Association of Hepatitis C Virus Infection With Prevalence and Development of Kidney Disease

Association of Hepatitis C Virus Infection With Prevalence and Development of Kidney Disease

Conversion of liver transplant recipients on cyclosporine with renal impairment to mycophenolate mofetil

Sicca syndrome associated with hepatitis C virus infection

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