Hepatitis C virus risk: a hepatitis C virus related syndrome

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A Protocol for Analyzing Hepatitis C Virus Replication
13:04

A Protocol for Analyzing Hepatitis C Virus Replication

Published on: June 26, 2014

C Mazzaro1, G Panarello, F Tesio

  • 1First Division of Medicine, Blood Bank Service of Pordenone General Hospital, Pordenone, Italy.

Journal of Internal Medicine
|May 16, 2000
PubMed

Insights

Hepatitis C virus (HCV)-positive patients with mixed cryoglobulinemia (MC) and kidney involvement have a new syndrome with poor survival but do not progress to kidney failure. Infections are the main cause of death in these patients.

Area of Science:

  • Nephrology
  • Hepatology
  • Immunology

Background:

  • Hepatitis C virus (HCV) infection is associated with mixed cryoglobulinemia (MC).
  • The long-term prognosis of HCV-positive patients with MC requires further investigation, particularly regarding kidney involvement.

Purpose of the Study:

  • To evaluate the long-term prognosis of hepatitis C virus-positive patients with mixed cryoglobulinemia.
  • To compare outcomes between patients with and without kidney involvement.

Main Methods:

  • 119 HCV-positive patients with MC were divided into two groups: without kidney involvement (Group A, 103 patients) and with glomerulonephritis (GN) (Group B, 16 patients).
  • 37 patients with mesangio-proliferative glomerulonephritis (MPGN) served as controls (Group C).
  • HCV RNA, genotype, and antibodies were determined. Liver, bone marrow, and kidney biopsies were performed as indicated.

Main Results:

  • Group B patients (MC with GN) had poorer survival (50% at 5 years) compared to Group A (87.4%) and Group C (89.5%).
  • Younger age, higher blood pressure, lower C4 levels, and poorer survival distinguished Group B from Group A.
  • No patient in Group B developed kidney failure requiring dialysis; infections were the leading cause of death.

Conclusions:

  • HCV-positive patients with MC and kidney involvement may represent a distinct syndrome (HCV-Risk syndrome).
  • This syndrome is characterized by immune system impairment, lack of progression to kidney failure, and poor survival.
  • Infections are a significant cause of mortality in this patient group.
Abstract

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