Hepatitis C virus and its renal manifestations: a review and update

Area of Science:

• Nephrology
• Hepatology
• Virology

Background:

• Hepatitis C virus (HCV) primarily targets the liver but frequently causes systemic illness, including various renal diseases.
• Chronic HCV infection is linked to glomerulonephritis, particularly membranoproliferative glomerulonephritis (MPGN) with or without cryoglobulinemia and membranous glomerulonephritis.
• End-stage kidney disease patients have higher HCV acquisition risk, and HCV presence increases mortality in dialysis and transplant recipients.

Purpose of the Study:

• To review the pathophysiology of HCV-induced renal manifestations.
• To discuss current diagnostic and therapeutic strategies for HCV-related glomerulopathies.
• To outline the management approach for HCV-infected dialysis patients and transplant candidates.

Main Methods:

• Literature review focusing on pathophysiology, diagnosis, and treatment of HCV-related kidney disease.
• Analysis of current data on renal manifestations in chronic HCV infection.
• Examination of management strategies for HCV in dialysis and renal transplant settings.

Main Results:

• HCV infection is a significant cause of glomerulonephritis, with specific types linked to cryoglobulinemia.
• HCV poses increased mortality risks for dialysis patients and renal transplant recipients.
• Optimal antiviral therapies for HCV in severe renal insufficiency are not well-defined and often have significant side effects.

Conclusions:

• HCV infection necessitates comprehensive renal evaluation and management.
• Further research is needed to establish effective and safe antiviral treatments for HCV in patients with renal impairment.
• Careful work-up and management are crucial for HCV-positive patients undergoing renal transplantation.