Glomerular disease during HCV infection in renal transplantation.
In general nephrology, HCV infection has been associated with type I membranoproliferative glomerulonephritis (MPGN type I) associated with cryoglobulinaemia. In a cohort of 399 renal transplantation (RT) recipients, 117 of whom (29%) were HCV-positive, we selected all patients diagnosed as having membranous GN or type I MPGN by graft biopsy. The prevalence of MGN was 16/399 (4%) with three recurrences, and 13 de novo cases. Only 5/16 (31%) were HCV+, not different from the general RT population. Five patients had an outcome of graft failure after 43 months. Conversely, there were 15 cases of type I MPGN (two recurrences, 13 de novo) but with eight HCV+ recipients (53%, P = 0.02). Considering only the French patients, prevalence was 44% vs 12% in the French RT population (P = 0.006). Eight patients had graft rejection after 59 months (five HCV+). In this type I MPGN subgroup, there were two positive cryoglobulins, two rheumatoid factors and four hypocomplementaemias. In conclusion, there is a clear association between HCV infection and the occurrence of type I MPGN in the allograft in renal transplantation, with terminal renal failure as an outcome.
Hammoud
H
H
Department of Nephrology, Dialysis and Renal Transplantation, Saint-Etienne Teaching Hospital, France.
Haem
J
J
Laurent
B
B
Alamartine
E
E
Diab
N
N
Defilippis
J P
JP
Berthoux
P
P
Berthoux
F
F
D000293:Adolescent; D000328:Adult; D000368:Aged; D000914:Antibodies, Viral / Q000032:analysis; D001706:Biopsy; D002648:Child; D003449:Cryoglobulinemia / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D015432:Glomerulonephritis, Membranoproliferative / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D016174:Hepacivirus / Q000235:genetics / Q000276:immunology; D006526:Hepatitis C / Q000150:complications*; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D015995:Prevalence; D011379:Prognosis; D012367:RNA, Viral / Q000032:analysis; D012008:Recurrence; D051437:Renal Insufficiency / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies
D000914:Antibodies, Viral; D012367:RNA, Viral