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Hepatitis C virus-related cryoglobulinemic glomerulonephritis: long-term remission after antiviral therapy

Paolo Rossi1, Tullio Bertani, Piero Baio

  • 1U.O. di Medicina Interna I, Ospedali Riuniti, Bergamo, Italy.

Kidney International
|May 20, 2003
PubMed

Insights

Hepatitis C virus (HCV) patients with cryoglobulinemic glomerulonephritis (CGN) showed significant clinical and histologic improvements after 12 months of antiviral therapy with interferon-alpha (IFN-alpha) and ribavirin. Sustained virologic response led to long-term benefits in kidney function.

Area of Science:

  • Nephrology
  • Hepatology
  • Immunology

Background:

  • Renal involvement in Hepatitis C Virus (HCV) infection often presents as cryoglobulinemic glomerulonephritis (CGN).
  • Standard antiviral therapy (interferon-alpha and ribavirin) can be challenging in anemic CGN patients.
  • Long-term clinical and histologic outcomes of this regimen in CGN patients were previously unreported.

Observation:

  • Three patients with HCV-related CGN and mild kidney impairment received 12 months of IFN-alpha and ribavirin therapy.
  • Two anemic patients were pretreated with erythropoietin (EPO).
  • Renal biopsies were performed pre-therapy and 14-26 months post-therapy.

Findings:

  • All patients achieved sustained virologic response, leading to marked clinical, biochemical, immunologic, and histologic improvements.
  • Clinical and biochemical markers normalized or neared normal by follow-up.
  • Some immunologic markers (C4, rheumatoid factor) remained abnormal in some patients; post-treatment biopsies showed mild residual activity.

Implications:

  • Antiviral therapy with IFN-alpha and ribavirin offers significant benefits for HCV-related CGN patients achieving sustained virologic response.
  • This treatment approach can improve renal function and histology in this patient population.
  • Further research may explore optimizing immunologic marker normalization and long-term renal outcomes.
Abstract

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