HCV associated glomerulopathy in Egyptian patients: clinicopathological analysis.
BACKGROUND
Hepatitis C virus (HCV) infection in Egypt has reached an epidemic proportion and is associated with many extra hepatic manifestations; Glomerulonephritis (GN) is one of the most consequences of HCV infection often resulting in end stage renal disease in some cases. Detection of viral genome or particles within the kidney biopsies from HCV-infected patients has proven to be difficult. Histological characterization of renal lesions still represents a major challenge. The aim of our work was to describe the histological pattern of HCV-associated nephropathy.


METHODS
Fifty Patients--out of 233--presented to Mansoura Urology and Nephrology clinic with manifestations of glomerular disease were screened for HCV antibodies by a 3rd generation ELISA test. Those tested positive for HCV antibodies were confirmed by PCR for HCV-RNA and subjected to more detailed clinical, biochemical and histological study. Kidney biopsies and in appropriate cases liver biopsies were examined by LM and electron microscopy (EM).


RESULTS
Histological study of renal biopsies revealed membranoproliferative (MPGN) type 1 to be the most common lesion encountered (54%), followed by focal segmental glomerulosclerosis (FSGS) (24%), mesangioproliferative GN (18%), membranous nephropathy (MN) (4%) in that order. EM examinations of renal biopsies were successful in identifying HCV like particles in frozen renal tissue.


CONCLUSIONS
HCV-associated glomerulopathy is a distinct category of glomerulonephritis. Results of LM showed some peculiar features. In addition, we were successful in location and detection of HCV particles in renal tissues by EM.
Sabry
Alaa
A
Nephrology Department, Mansoura Urology and Nephrology Center, Mansoura University, Egypt. asabry20@yahoo.com
E-Agroudy
Amgd
A
Sheashaa
Hussein
H
El-Husseini
Amr
A
Mohamed Taha
Nohir
N
Elbaz
Mahmoud
M
Sobh
Mohamed
M
D000328:Adult; D001483:Base Sequence; D004279:DNA, Viral / Q000235:genetics / Q000302:isolation & purification; D004534:Egypt / Q000453:epidemiology; D005260:Female; D005921:Glomerulonephritis / Q000209:etiology* / Q000473:pathology* / Q000821:virology; D016174:Hepacivirus / Q000235:genetics / Q000302:isolation & purification / Q000648:ultrastructure; D006526:Hepatitis C / Q000150:complications* / Q000453:epidemiology / Q000473:pathology / Q000821:virology; D006801:Humans; D007668:Kidney / Q000473:pathology / Q000821:virology; D008297:Male; D008854:Microscopy, Electron; D008875:Middle Aged; D016133:Polymerase Chain Reaction
D004279:DNA, Viral