title: Remission of HCV-associated glomerulonephritis with pegylated ifn and ribavirin therapy after liver transplantation: case report and literature review.
abstract: BACKGROUND
  Hepatitis C virus infection is associated with a variety of extrahepatic disorders such as membrano-proliferative glomerulonephritis, which is generally due to cryoglobulinemia.
  
  
  METHODS
  We describe the case of one liver transplant recipient who received antiviral therapy (subcutaneous administration of peg-IFN-alpha-2a 180 mcg weekly and oral ribavirin 200 mg thrice a day)  for HCV-related membrano-proliferative glomerulonephritis. He presented normal kidney function, non-nephrotic proteinuria (2 g/24 h) and mild hematuria.
  
  
  RESULTS
  Urinary abnormalities disappeared within a few weeks after the initiation of antiviral therapy; however, combination antiviral therapy was not able to obtain viral clearance. After 11 months, IFN-therapy was interrupted and the patient continued low-dose ribavirin monotherapy (200 mg once per day) for one additional year- remission of proteinuria (<0.3 g/24 h) and hematuria persisted with intact kidney function. Although other mechanisms cannot be excluded, we suggest that ribavirin therapy was critically implicated in the remission of urinary abnormalities in our patient. The existing literature on the association between HCV-associated glomerulonephritis and therapy with ribavirin is reviewed.
  
  
  CONCLUSIONS
  Antiviral therapy may be effective in patients with HCV-induced glomerulonephritis.  Further evidence is needed to evaluate efficacy and safety of ribavirin monotherapy for HCV-related glomerulonephritis.
authors.affiliation: Division of Gastroenterology, Maggiore Hospital and University School of Medicine, Milan, Italy.
authors.forename: Maria Francesca
authors.initials: MF
authors.lastname: Donato
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Fabrizi
authors.forename: Giovanni Battista
authors.initials: GB
authors.lastname: Fogazzi
authors.forename: Donata
authors.initials: D
authors.lastname: Cresseri
authors.forename: Patrizia
authors.initials: P
authors.lastname: Passerini
authors.forename: Paul
authors.initials: P
authors.lastname: Martin
authors.forename: Piergiorgio
authors.initials: P
authors.lastname: Messa
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000601:surgery* / Q000821:virology; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D015433:Glomerulonephritis, Membranous / Q000175:diagnosis / Q000188:drug therapy* / Q000821:virology; D019698:Hepatitis C, Chronic / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016898:Interferon-alpha / Q000627:therapeutic use*; D008113:Liver Neoplasms / Q000175:diagnosis / Q000601:surgery* / Q000821:virology; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000627:therapeutic use*; D011994:Recombinant Proteins / Q000627:therapeutic use; D012074:Remission Induction; D012254:Ribavirin / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D007166:Immunosuppressive Agents; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C100416:peginterferon alfa-2a