RESEARCH - Treatment of hepatitis C-virus-related glomerulonephritis

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Kidney Int. 2006 Feb;69(3):436-9.

Treatment of hepatitis C-virus-related glomerulonephritis.

Kamar N, Rostaing L, Alric L.

Department of Nephrology, Dialysis, and Multiorgan Transplantation, CHU

Rangueil, Toulouse University Hospital, Toulouse, France.

alric.L@...

Membranoproliferative glomerulonephritis (MPGN) associated with type II

cryoglobulinemia is the predominant type of hepatitis C virus (HCV)-related

glomerulonephritis. The blockade of the renin-angiotensin system, as well as

a combined anti-HCV therapy that associates standard or pegylated

alpha-interferon with ribavirin, are mandatory in all patients experiencing

an HCV-related glomerulonephritis. In patients with nephrotic-range

proteinuria and/or progressive renal failure, immunosuppressive therapy is

necessary. Rituximab, the monoclonal anti-CD20 antibody that selectively

targets the B cells, seems to be as least as efficient as cyclophosphamide.

Because it is also better tolerated, it should be preferred to

cyclophosphamide. During the acute phase, plasmapheresis and steroid pulses

can be used. However, future prospective, controlled, and randomized studies

are still required to establish evidence-based guidelines to treat

HCV-related glomerulopathies.

PMID: 16514428

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=pubmed & dopt=Abstra\

ct & list_uids=16514428 & itool=iconabstr & query_hl=119 & itool=pubmed_DocSum

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