Effect of antiviral therapy on hepatitis C virus related glomerulopathy

الملخص EN

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.