PREVALENCE OF HEPATITIS-C IN PATIENTS WITH IDIOPATHIC GLOMERULOPATHIES IN NATIVE AND TRANSPLANT KIDNEYS

Previous studies suggest that there is an association between hepatiti s C (HCV) infection and glomerular diseases in native and transplanted kidneys. However, the data are controversial. To reexamine this issue , we determined the prevalence of serum anti-HCV antibodies in patient s with glomerulopathies of native kidneys (n = 105) and in patients wi th acute and chronic transplant glomerulopathy (TxGN) (n = 62). Compar ed with a control group of patients with diabetic nephropathy (n = 37, 0% HCV+), the prevalence of HCV antibodies was significantly higher i n patients with focal glomerulosclerosis (FGS) (4 of 32, 13%, P = 0.04 by chi-square), but not in patients with membraneous nephropathy (MGN ) (1 of 19, 5%) or in patients with membranoproliferative glomerulonep hritis (MPGN) (2 of 17, 12%). All of the patients with positive HCV se rology had histories of intravenous (IV) drug use. Thus, HCV serology was negative in all of the patients with native glomerulopathies witho ut histories of IV drug use. Compared with a group of 105 transplant p atients without TxGN (1.8% HCV+), the prevalence of HCV antibodies was significantly higher in patients with acute (A)TxGN (12 or 41: 29%. P = 0.0004) and in patients with chronic (C)TxGN (9 of 27: 33%. P = 0.0 004). Compared with controls, patients with ATxGN also had a significa ntly higher prevalence of serum immunoglobulin (Ig) M antibodies to cy tomegalovirus (CMV) (3% and 26% of patients, respectively, P = 0.0004) . However, there were no statistical associations between HCV and CMV serologies. These results do not support the postulate that HCV infect ion is associated with idiopathic native glomerulopathies; instead, th e data suggest that the presence of HCV positivity in these patients c an be explained by the inclusion of patients with a history of IV drug use. In contrast, these studies demonstrate for the first time an ass ociation between HCV infection and transplant glomerulopathies. (C) 19 96 by the National Kidney Foundation, Inc.