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The role of hepatitis C virus infection in glomerulopathy
1Second Department of Internal Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Japan
Insights
Hepatitis C virus (HCV) infection is linked to glomerulopathy, a kidney disease. Cryoglobulinemia often indicates kidney problems in patients with HCV-associated glomerulopathy.
Area of Science:
- Nephrology
- Hepatology
- Virology
Background:
- Hepatitis C virus (HCV)-associated glomerulopathy characteristics and prevalence require further investigation.
- Understanding the link between HCV infection and kidney disease is crucial for patient management.
Purpose of the Study:
- To analyze the association between Hepatitis C virus (HCV) infection and glomerulopathy.
- To determine the role of cryoglobulinemia in renal insufficiency among HCV-infected patients.
Main Methods:
- Cross-sectional study involving 7776 individuals for routine checkups.
- Comparative analysis of patients with chronic hepatitis C, chronic hepatitis B, and non-viral liver diseases.
- Renal biopsy in nine patients with histologically confirmed HCV-associated glomerulopathy.
Main Results:
- HCV antibody positivity was 1.8% in the general population; HCV antibody-positive individuals showed higher proteinuria rates.
- Patients with chronic hepatitis C exhibited significantly higher rates of abnormal serum creatinine and cryoglobulinemia compared to other liver disease groups.
- Cryoglobulinemia was present in all patients with abnormal serum creatinine and was associated with elevated creatinine and membranoproliferative glomerulonephritis in HCV-associated glomerulopathy cases.
Conclusions:
- HCV infection is significantly associated with the development of glomerulopathy.
- Cryoglobulinemia serves as an indicator of renal insufficiency in patients suffering from HCV-associated glomerulopathy.
- Membranoproliferative glomerulonephritis is a common finding in HCV-associated glomerulopathy, particularly in the presence of cryoglobulinemia.
Abstract:
The characteristics and prevalence of hepatitis C virus (HCV)-associated glomerulopathy remain to be determined. To analyze the relationship between HCV infection and glomerulopathy, we enrolled three groups of individuals or patients. The first group consisted of 7776 individuals who were seen for routine checkups. The second group consisted of 86 patients with chronic hepatitis C, 40 patients with chronic hepatitis B, and 51 patients with non-viral liver diseases. The third group consisted of nine patients with HCV association glomerulopathy who underwent renal biopsy. Of the 7776 individuals undergoing medical checkups, 142 (1.8%) were positive for HCV antibody. The positive rate of proteinuria was significantly higher (P<0.030) in individuals with HCV antibody (2.1%) than in those without the antibody (0.6%). Abnormal levels of serum creatinine (5.8 vs. 0%, P=0.025) and complications of cryoglobulinemia (45 vs. 5%, P<0.001) were significantly more common in the 86 patients with chronic hepatitis C (5.8%) than in the 91 patients with other liver diseases. All patients with abnormal levels of serum creatinine had concomitant cryoglobulinemia. Of the nine patients with histologically proven HCV-associated glomerulopathy, four had cryoglobulinemia (all were type II). Elevations of serum creatinine level (4/4 vs. 0/5, P=0.048) and a glomerular legion of membranoproliferative glomerulonephritis (3/4 vs. 0/5, P=0.048), a severe type of glomerulonephritis, were more common in the four patients with cryoglobulinemia than in the remaining five patients. In conclusion, HCV infection was found to be significantly associated with glomerulopathy. In addition, the presence of cryoglobulinemia, which usually accompanies membranoproliferative glomerulonephritis, was found to be an indicator of renal insufficiency in patients with HCV-associated glomerulopathy.