Ribavirin monotherapy for hepatitis C virus-associated membranous nephropathy

Glomerular diseases associated with hepatitis C virus (HCV) infection are increasingly being recognized. Antiviral therapy with interferon-alpha (IFN-alpha) and ribavirin eradicate viral activity in a significant proportion of patients with chronic active hepatitis, often with amelioration of extrahepatic manifestations, including glomerular pathology. Unfortunately, adverse effects often preclude the use of IFN-alpha. We describe a patient with refractory nephrotic syndrome secondary to HCV-associated membranous nephropathy who sustained a complete remission following the initiation of ribavirin monotherapy. The existing literature on the association between these two disorders and therapy with ribavirin is reviewed.