Hepatitis C virus infection in nephrology patients

Hepatitis C virus (HCV) infection leads to chronic liver disease, but also to extra-hepatic manifestations. These include mixed cryoglobulinemia, lymphoproliferative disorders, and renal disease. HCV infection has been reported in association with distinct histological patterns of glomerulonephritis in native kidneys. Membranoproliferative glomerulonephritis (MPGN) associated with type II cryoglobulinemia is the predominant type of HCV-related glomerulonephritis. Less common glomerulonephritis diseases have also been reported in HCV-infected patients: these include MPGN without cryoglobulinemia, membranous glomerulonephritis (MGN), focal segmental glomerular sclerosis, proliferative glomerulonephritis, and fibrillary and immunotactoid glomerulopathies. Other anecdotal case reports have been also published: HCV-related IgA nephropathy, rapidly progressive glomerulonephritis, and thrombotic microangiopathy associated with cryoglobulinemic MPGN. However, whether a causative effect between these glomerular diseases and HCV infection exists is still unknown.