Hepatitis C-related membranoproliferative glomerulonephritis in the era of direct antiviral agents

Abstract Membranoproliferative glomerulonephritis (MPGN) is the most typical Hepatitis C virus (HCV)-associated glomerulopathy, and the available data about the utilization of direct-acting antivirals (DAA) in HCV-associated glomerulonephritis is inadequate. We evaluated the renal and viral response in two cases of HCV-related MPGN; the first caused by cryoglobulinemia while the second was cryoglobulin-negative. Both patients received immunosuppression besides DAA in different regimens. They achieved partial remission but remained immunosuppression-dependent for more than 6 months after DAA despite sustained virological response, which enabled safer but incomplete immunosuppression withdrawal. Both patients were tested for occult HCV in peripheral blood mononuclear cells and found to be negative. Hence, the treatment of HCV-related MPGN ought to be according to the clinical condition and the effects of drug therapy. It is important to consider that renal response can lag behind the virological response.

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Main Authors: Abdelhamid,Walid Ahmed Ragab, Shendi,Ali, Zahran,Mahmoud, Elbary,Eman Abd, Fadda,Sawsan
Format: Digital revista
Language:English
Published: Sociedade Brasileira de Nefrologia 2022
Online Access:http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002022000200291
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spelling oai:scielo:S0101-280020220002002912022-06-21Hepatitis C-related membranoproliferative glomerulonephritis in the era of direct antiviral agentsAbdelhamid,Walid Ahmed RagabShendi,AliZahran,MahmoudElbary,Eman AbdFadda,Sawsan Virology Immune System Proteinuria Sustained Virologic Response Cryoglobulinemia Mycophenolic Acid Abstract Membranoproliferative glomerulonephritis (MPGN) is the most typical Hepatitis C virus (HCV)-associated glomerulopathy, and the available data about the utilization of direct-acting antivirals (DAA) in HCV-associated glomerulonephritis is inadequate. We evaluated the renal and viral response in two cases of HCV-related MPGN; the first caused by cryoglobulinemia while the second was cryoglobulin-negative. Both patients received immunosuppression besides DAA in different regimens. They achieved partial remission but remained immunosuppression-dependent for more than 6 months after DAA despite sustained virological response, which enabled safer but incomplete immunosuppression withdrawal. Both patients were tested for occult HCV in peripheral blood mononuclear cells and found to be negative. Hence, the treatment of HCV-related MPGN ought to be according to the clinical condition and the effects of drug therapy. It is important to consider that renal response can lag behind the virological response.info:eu-repo/semantics/openAccessSociedade Brasileira de NefrologiaBrazilian Journal of Nephrology v.44 n.2 20222022-06-01info:eu-repo/semantics/articletext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002022000200291en10.1590/2175-8239-jbn-2020-0148
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countrycode BR
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libraryname SciELO
language English
format Digital
author Abdelhamid,Walid Ahmed Ragab
Shendi,Ali
Zahran,Mahmoud
Elbary,Eman Abd
Fadda,Sawsan
spellingShingle Abdelhamid,Walid Ahmed Ragab
Shendi,Ali
Zahran,Mahmoud
Elbary,Eman Abd
Fadda,Sawsan
Hepatitis C-related membranoproliferative glomerulonephritis in the era of direct antiviral agents
author_facet Abdelhamid,Walid Ahmed Ragab
Shendi,Ali
Zahran,Mahmoud
Elbary,Eman Abd
Fadda,Sawsan
author_sort Abdelhamid,Walid Ahmed Ragab
title Hepatitis C-related membranoproliferative glomerulonephritis in the era of direct antiviral agents
title_short Hepatitis C-related membranoproliferative glomerulonephritis in the era of direct antiviral agents
title_full Hepatitis C-related membranoproliferative glomerulonephritis in the era of direct antiviral agents
title_fullStr Hepatitis C-related membranoproliferative glomerulonephritis in the era of direct antiviral agents
title_full_unstemmed Hepatitis C-related membranoproliferative glomerulonephritis in the era of direct antiviral agents
title_sort hepatitis c-related membranoproliferative glomerulonephritis in the era of direct antiviral agents
description Abstract Membranoproliferative glomerulonephritis (MPGN) is the most typical Hepatitis C virus (HCV)-associated glomerulopathy, and the available data about the utilization of direct-acting antivirals (DAA) in HCV-associated glomerulonephritis is inadequate. We evaluated the renal and viral response in two cases of HCV-related MPGN; the first caused by cryoglobulinemia while the second was cryoglobulin-negative. Both patients received immunosuppression besides DAA in different regimens. They achieved partial remission but remained immunosuppression-dependent for more than 6 months after DAA despite sustained virological response, which enabled safer but incomplete immunosuppression withdrawal. Both patients were tested for occult HCV in peripheral blood mononuclear cells and found to be negative. Hence, the treatment of HCV-related MPGN ought to be according to the clinical condition and the effects of drug therapy. It is important to consider that renal response can lag behind the virological response.
publisher Sociedade Brasileira de Nefrologia
publishDate 2022
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002022000200291
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