title: Lupus-like Immune Complex-mediated Glomerulonephritis in Patients with Hepatitis C Virus Infection Treated with Oral, Interferon-free, Direct-acting Antiviral Therapy.
abstract: Novel, all-oral interferon-free direct-acting antiviral agents have revolutionized the management of hepatitis C virus (HCV) infection by producing exceptional cure rates with minimal adverse events. While provocation or exacerbation of autoimmunity has been reported in HCV-infected patients receiving interferon, this phenomenon has not been reported in patients receiving interferon-free HCV therapy. We report the occurrence of three cases of lupus-like immune complex-mediated glomerulonephritis occurring shortly after exposure to sofosbuvir-based direct-acting antiviral therapies. In all three cases, renal function quickly improved with immunosuppression. However, two of the three patients developed infectious complications of immunosuppression and died. This is the first report of a lupus-like immune complex mediated glomerulonephritis occurring in the context of HCV eradication with all-oral direct-acting antiviral therapies.
authors.affiliation: Division of Nephrology, Department of Medicine, Massachusetts General Hospital, Boston, MA.
authors.forename: Meghan E
authors.initials: ME
authors.lastname: Sise
authors.affiliation: Gastrointestinal Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA.
authors.forename: Jessica
authors.initials: J
authors.lastname: Wisocky
authors.affiliation: Department of Pathology, Massachusetts General Hospital, Boston, MA.
authors.forename: Ivy A
authors.initials: IA
authors.lastname: Rosales
authors.affiliation: Gastrointestinal Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA.
authors.forename: Donald
authors.initials: D
authors.lastname: Chute
authors.affiliation: Gastrointestinal Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA.
authors.forename: Jacinta A
authors.initials: JA
authors.lastname: Holmes
authors.affiliation: Division of Nephrology, Department of Medicine, Massachusetts General Hospital, Boston, MA.
authors.forename: Kristin M
authors.initials: KM
authors.lastname: Corapi
authors.affiliation: Division of Nephrology, Department of Medicine, Massachusetts General Hospital, Boston, MA.
authors.forename: Jodie L
authors.initials: JL
authors.lastname: Babitt
authors.affiliation: Division of Nephrology, Department of Medicine, Massachusetts General Hospital, Boston, MA.
authors.forename: Jessica S
authors.initials: JS
authors.lastname: Tangren
authors.affiliation: Department of Gastroenterology and Hepatology, Brigham and Women's Hospital, Boston, MA.
authors.forename: Nikroo
authors.initials: N
authors.lastname: Hashemi
authors.affiliation: Division of Nephrology, Department of Medicine, Massachusetts General Hospital, Boston, MA.
authors.forename: Andrew L
authors.initials: AL
authors.lastname: Lundquist
authors.affiliation: Division of Nephrology, Department of Medicine, Massachusetts General Hospital, Boston, MA.
authors.forename: Winfred W
authors.initials: WW
authors.lastname: Williams
authors.affiliation: Renal Unit, Brigham and Women's Hospital, Boston, MA.
authors.forename: David B
authors.initials: DB
authors.lastname: Mount
authors.affiliation: Gastrointestinal Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA.
authors.forename: Karin L
authors.initials: KL
authors.lastname: Andersson
authors.affiliation: Department of Pathology, Brigham and Women's Hospital, Boston, MA.
authors.forename: Helmut G
authors.initials: HG
authors.lastname: Rennke
authors.affiliation: Department of Pathology, Massachusetts General Hospital, Boston, MA.
authors.forename: R Neal
authors.initials: RN
authors.lastname: Smith
authors.affiliation: Department of Pathology, Massachusetts General Hospital, Boston, MA.
authors.forename: Robert
authors.initials: R
authors.lastname: Colvin
authors.affiliation: Division of Nephrology, Department of Medicine, Massachusetts General Hospital, Boston, MA.
authors.forename: Ravi I
authors.initials: RI
authors.lastname: Thadhani
authors.affiliation: Gastrointestinal Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA.
authors.forename: Raymond T
authors.initials: RT
authors.lastname: Chung