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Adv Chronic Kidney Dis. 2015 Sep;22(5):343-51. doi: 10.1053/j.ackd.2015.06.003.

Glomerular Diseases Associated With Hepatitis B and C.

Author information

1
Department of Medicine, Division of Nephrology, University at Buffalo School of Medicine and Biomedical Sciences, Buffalo, NY.
2
Department of Medicine, Division of Nephrology, University at Buffalo School of Medicine and Biomedical Sciences, Buffalo, NY. Electronic address: rquigg@buffalo.edu.

Abstract

Infections with hepatitis B virus (HBV) and hepatitis C virus (HCV) are prevalent worldwide. In this review, we discuss the epidemiology, pathogenesis, clinical manifestations, and treatment of HBV- and HCV-related glomerulonephritis (GN). The most common histopathologic presentation of HBV-GN is HBV-associated membranous nephropathy, which usually manifests clinically with varying grades of proteinuria and microscopic hematuria. The pathogenesis is likely to be immune complex mediated; however, other host and viral factors have been implicated. The treatment of HBV-GN revolves around antiviral therapy. Various histologic types of glomerular diseases are reported in association with HCV infection, the most frequent being Type 1 membranoproliferative glomerulonephritis, usually in the context of Type 2 mixed cryoglobulinemia. The pathogenesis of HCV-GN can be attributed to glomerular deposition of cryoglobulins or noncryoglobulin-immune complexes. Cryoglobulins typically comprised immunoglobulin Mκ with rheumatoid factor activity. Clinically, patients may present with proteinuria, microscopic hematuria, hypertension, and acute nephritic and/or nephrotic syndrome. The treatment of HCV-GN, especially cryoglobulinemic membranoproliferative glomerulonephritis, encompasses various options including contemporary antiviral therapy with or without conventional and novel immunomodulatory agents.

KEYWORDS:

Cryoglobulinemia; Glomerulonephritis; Hepatitis B; Hepatitis C

PMID:
26311595
DOI:
10.1053/j.ackd.2015.06.003
[Indexed for MEDLINE]

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