title: Glomerular Diseases Associated With Hepatitis B and C.
abstract: Infections with hepatitis B virus (HBV) and hepatitis C virus (HCV) are prevalent worldwide. In this review, we discuss the epidemiology, pathogenesis, clinical manifestations, and treatment of HBV- and HCV-related glomerulonephritis (GN). The most common histopathologic presentation of HBV-GN is HBV-associated membranous nephropathy, which usually manifests clinically with varying grades of proteinuria and microscopic hematuria. The pathogenesis is likely to be immune complex mediated; however, other host and viral factors have been implicated. The treatment of HBV-GN revolves around antiviral therapy. Various histologic types of glomerular diseases are reported in association with HCV infection, the most frequent being Type 1 membranoproliferative glomerulonephritis, usually in the context of Type 2 mixed cryoglobulinemia. The pathogenesis of HCV-GN can be attributed to glomerular deposition of cryoglobulins or noncryoglobulin-immune complexes. Cryoglobulins typically comprised immunoglobulin Mκ with rheumatoid factor activity. Clinically, patients may present with proteinuria, microscopic hematuria, hypertension, and acute nephritic and/or nephrotic syndrome. The treatment of HCV-GN, especially cryoglobulinemic membranoproliferative glomerulonephritis, encompasses various options including contemporary antiviral therapy with or without conventional and novel immunomodulatory agents.
authors: Department of Medicine, Division of Nephrology, University at Buffalo School of Medicine and Biomedical Sciences, Buffalo, NY.
authors: Anu
authors: A
authors: Gupta
authors: Department of Medicine, Division of Nephrology, University at Buffalo School of Medicine and Biomedical Sciences, Buffalo, NY. Electronic address: rquigg@buffalo.edu.
authors: Richard J
authors: RJ
authors: Quigg
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use; D015897:Comorbidity; D018450:Disease Progression; D005260:Female; D005919:Glomerular Filtration Rate; D005921:Glomerulonephritis / Q000188:drug therapy / Q000453:epidemiology* / Q000473:pathology / Q000821:virology*; D006509:Hepatitis B / Q000188:drug therapy / Q000453:epidemiology* / Q000503:physiopathology; D006526:Hepatitis C / Q000188:drug therapy / Q000453:epidemiology* / Q000503:physiopathology; D006801:Humans; D007677:Kidney Function Tests; D008297:Male; D011379:Prognosis; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents
keywords: Cryoglobulinemia; Glomerulonephritis; Hepatitis B; Hepatitis C