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Hepatitis C virus infection and membranoproliferative glomerulonephritis in Japan
H Yamabe1, R J Johnson, D R Gretch
1Second Department of Internal Medicine, Hirosaki University School of Medicine, Japan.
Insights
Hepatitis C virus (HCV) infection is prevalent in Japanese patients with membranoproliferative glomerulonephritis (MPGN). This finding suggests HCV may play a role in MPGN pathogenesis and clinical presentation.
Area of Science:
- Nephrology
- Virology
- Immunology
Background:
- Glomerulonephritis encompasses various kidney diseases.
- Hepatitis C virus (HCV) infection is a global health concern.
- The association between HCV and specific glomerulonephritis types requires further investigation.
Purpose of the Study:
- To determine the prevalence of HCV infection in adult patients with different types of glomerulonephritis.
- To compare HCV prevalence across various renal diseases.
- To explore clinical differences in MPGN associated with HCV.
Main Methods:
- Serum HCV antibody (HCV Ab) testing was performed on 146 patients with glomerulonephritis.
- Positive HCV Ab cases were confirmed using HCV RNA polymerase chain reaction (PCR).
- Prevalence rates were compared between disease groups and healthy controls.
Main Results:
- HCV infection was detected in 60% of membranoproliferative glomerulonephritis (MPGN) Type I cases, significantly higher than other glomerulonephritis types (P < 0.001).
- HCV prevalence in MPGN was notably higher than in immunoglobulin A nephropathy, lupus nephritis, minimal change nephrosis, and other renal diseases.
- HCV-positive MPGN patients exhibited increased liver dysfunction, cryoglobulinemia, rheumatoid factor, and hypocomplementemia compared to idiopathic MPGN.
Conclusions:
- HCV infection is highly prevalent in Japanese patients with MPGN.
- HCV may contribute to the development or progression of MPGN.
- HCV-associated MPGN may present with distinct clinical and laboratory features.
Abstract:
The prevalence of hepatitis C virus (HCV) infection was determined in 146 adult patients with various types of glomerulonephritis and renal diseases monitored between 1990 and 1993. Serum HCV antibody (HCV Ab) was evaluated, and positive cases were tested for HCV RNA by polymerase chain reaction. HCV infection was present in 1 (1.7%) of 58 cases of immunoglobulin A nephropathy, 0 (0%) of 14 cases of lupus nephritis, 0 (0%) of 12 cases of minimal change nephrosis, and 0 (0%) of 28 cases of other renal diseases, which is similar to the 2% prevalence observed in healthy blood donors in Japan. In contrast, HCV Ab was observed in 2 (8.3%) of 24 cases of membranous nephropathy and 6 (60%) of 10 cases of membranoproliferative glomerulonephritis (MPGN) Type I. The prevalence of HCV infection in MPGN patients was significantly higher than the frequency of HCV infection observed in the other patients with renal diseases (P < 0.001). HCV RNA was present in all cases in which HCV Ab was present. The six patients with HCV-MPGN were similar to the four patients with idiopathic MPGN with respect to age, presence of nephrotic syndrome, and renal dysfunction, but had a higher incidence of liver dysfunction, cryoglobulinemia, rheumatoid factor, and hypocomplementemia (low C3). HCV infection is present in a large percentage of patients with MPGN in Japan and clinically may differ slightly from other cases of MPGN.