HCV-Associated Nephropathies in the Era of Direct Acting Antiviral Agents

Frontiers in Medicine
Andrea AngelettiPaolo Cravedi

Abstract

Hepatitis C virus (HCV) infection is a systemic disorder that frequently associates with extrahepatic manifestations, including nephropathies. Cryoglobulinemia is a typical extrahepatic manifestation of HCV infection that often involves kidneys with a histological pattern of membranoproliferative glomerulonephritis. Other, less common renal diseases related to HCV infection include membranous nephropathy, focal segmental glomerulosclerosis, IgA nephropathy, fibrillary and immunotactoid glomerulopathy. Over the last decades, the advent of direct-acting antiviral therapies has revolutionized treatment of HCV infection, dramatically increasing the rates of viral clearance. In patients where antiviral therapy alone fails to induce renal disease remission add-on B-cell depleting agents represent an alternative to counteract the synthesis of pathogenic antibodies. Immunosuppressive therapies, such as steroids, alkylating agents, and plasma exchanges, may still represent an effective option to inhibit immune-complex driven inflammatory response, but the potentially associated increase of HCV replication and worsening of liver disease represent a serious limitation to their use.

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Citations

Aug 15, 2020·Nature Reviews. Disease Primers·Jeffrey B KoppPaola Romagnani
Mar 18, 2021·Zeitschrift für Gastroenterologie·Florian Gunnar ScurtChristos Chatzikyrkou
Mar 16, 2021·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Humberto BohorquezAri J Cohen

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Methods Mentioned

BETA
light microscopy
electron microscopy

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