Hepatitis C virus

The nephrologist's view

Research output: Contribution to journalArticle

118 Citations (Scopus)

Abstract

The last 4 years have been a period of rapid expansion in our understanding of both the molecular biology and clinical significance of hepatitis C virus (HCV) infection. Initial studies using first-generation enzyme-linked immunosorbent assays suggested that the end-stage renal disease population had an exceptionally high prevalence of anti-HCV compared with asymptomatic healthy blood donors. Subsequent analyses with second-generation assays and polymerase chain reaction techniques to detect viremia confirmed these earlier studies. Considering the prevalence of HCV within the dialysis population, it comes as no surprise that several studies confirmed HCV as the leading cause of non-A, non-B hepatitis among renal allograft recipients. Furthermore, transmission of HCV by transplantation of a kidney from an HCV-infected organ donor has been unequivocally demonstrated. The natural history of HCV infection in the immunosuppressed allograft recipient and its impact on long-term patient outcome are still being analyzed. Finally, HCV has been associated with essential mixed cryoglobulinemia and several histologic patterns of immune complex glomerulonephritis, including membranous and membrano-proliferative glomerulonephritis. Although HCV antigen-antibody complexes have not been demonstrated in the kidney, the marked decrease in proteinuria following clearance of HCV RNA with interferon α-2b therapy suggests an etiologic role for HCV in these glomerular diseases. Furthermore, the demonstration of HCV RNA in the cryoprecipitate of patients with essential mixed cryoglobulinemia and a beneficial response to treatment with interferon α-2b also suggest a role for HCV in the pathogenesis of these clinical syndromes.

Original languageEnglish
Pages (from-to)3-16
Number of pages14
JournalAmerican Journal of Kidney Diseases
Volume25
Issue number1
DOIs
StatePublished - Jan 1 1995

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Hepacivirus
Cryoglobulinemia
Virus Diseases
Antigen-Antibody Complex
Interferons
Allografts
Nephrologists
Hepatitis C Antigens
RNA
Kidney
Membranous Glomerulonephritis
Hepatitis C Antibodies
Viremia
Glomerulonephritis
Blood Donors
Natural History
Proteinuria
Kidney Transplantation
Hepatitis
Population

Keywords

  • cryoglobulinemia
  • dialysis
  • glomerulonephritis
  • Hepatitis C virus
  • transplantation

ASJC Scopus subject areas

  • Nephrology

Cite this

Hepatitis C virus : The nephrologist's view. / Roth, David.

In: American Journal of Kidney Diseases, Vol. 25, No. 1, 01.01.1995, p. 3-16.

Research output: Contribution to journalArticle

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