| Theme | Extrahepatic Manifestation in HCV Infection | |
|---|---|---|
| Title | Membranoproliferative Glomerulonephritis Associated with Hepatitis C Virus Infections | |
| Publish Date | 1999/03 | |
| Author | Isao Ohsawa | Internal Medicine II,Nihon University School of Medcine |
| Author | Hiroyuki Ohi | Internal Medicine II,Nihon University School of Medcine |
| [ Summary ] | Since the early 1990's, the detection method for anti hepatitis C virus (HCV) antibodies has become generalized, it has made nephrologists recognize the association of membranoproliferative glomerulonephritis (MPGN) with HCV infections. The proportion of anti HCV antibodies positivity seen in MPGN varies from author to author. We examined nintythree patients with MPGN and found that 15% tested positive in Japan. HCV transforms B-cells so that they produce many types of antibodies(including rheumatoid factors), some of them had cryoglobulin the features These antibodies form immune compiexes with HCV and deposits in the glomerulus. Furthermore cryoglobulin desplayed nephritogenicity. There is a strong relationship between HCV infections, MPGN and cryoglobulin. The effect of interferon (IFN) therapy was examined in some reports. On the whole, good clinical responses can be expected in the first therapy, but invalid genotypes and recurrence after IFN therapy are serious problems. We must make a standard criteria for IFN therapy and design a plan for post-IFN maintenance therapy. Though immunosuppressive therapy is relatively contraindicated in infectious diseases, some authors have reported successful cases using glucocorticoid and cyclophosphamide. These reports suggest a new method of MPGN therapy. |
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