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Spectrum of Kidney Diseases in Patients With Hepatitis C Virus Infection

Shunhua Guo1, Meghan E Kapp2, Diego M Beltran3

  • 1Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.

American Journal of Clinical Pathology
|February 24, 2021
PubMed

Insights

Most kidney diseases in hepatitis C virus (HCV) patients are unrelated to HCV infection. HCV-associated glomerulonephritis (GN) presents with five patterns, and antiviral therapy has not yet altered this disease spectrum.

Area of Science:

  • Nephrology
  • Virology
  • Pathology

Background:

  • Hepatitis C virus (HCV) infection is associated with various extrahepatic manifestations, including kidney diseases.
  • Understanding the spectrum of kidney pathology in HCV-positive patients is crucial for diagnosis and management.

Purpose of the Study:

  • To investigate the range of kidney diseases observed in patients with hepatitis C virus infection.
  • To characterize the histologic patterns of HCV-associated glomerulonephritis (GN).

Main Methods:

  • Review of native kidney biopsy specimens from patients with confirmed hepatitis C virus infection.
  • Classification of kidney diseases based on histopathology, distinguishing between HCV-associated and non-HCV-associated conditions.

Main Results:

  • Out of 9,836 native kidney biopsies, 2.8% (273) were from HCV+ patients.
  • HCV-associated glomerulonephritis (GN) was diagnosed in 42.1% (115) of HCV+ patients.
  • Non-HCV-associated kidney diseases were more common (57.9%), including non-immune complex-mediated diseases (46.5%) and other immune complex-mediated glomerular diseases (11.4%).
  • HCV-associated GN exhibited five distinct morphologic patterns: focal proliferative, diffuse mesangial proliferative, diffuse membranoproliferative, proliferative GN with crescentic lesions, and membranous patterns.
  • The proportion of HCV-associated GN remained relatively stable between 2007-2011 and 2012-2016.

Conclusions:

  • The majority of kidney diseases in HCV+ patients are not directly caused by HCV infection.
  • HCV-associated GN demonstrates diverse morphologic presentations.
  • Current effective HCV antiviral therapies have not yet significantly impacted the spectrum of kidney diseases observed in these patients.
Abstract

Keywords:
CryoglobulinemiaHCV-associated glomerulonephritisHepatitis C virus (HCV)Kidney disease

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