GLOMERULAR-DISEASE DURING HCV INFECTION IN RENAL-TRANSPLANTATION

In general nephrology, HCV infection has been associated with type I m embranoproliferative glomerulonephritis (MPGN type I) associated with cryoglobulinaemia. In a cohort of 399 renal transplantation (RT) recip ients, 117 of whom (29%) were HCV-positive, we selected all patients d iagnosed as having membranous GN or type I MPGN by graft biopsy. The p revalence of MGN was 16/399 (4%) with three recurrences, and 13 de nov o cases. Only 5/16 (31%) were HCV +, not different from the general RT population. Five patients had an outcome of graft failure after 43 mo nths. Conversely, there were 15 cases of type I MPGN (two recurrences, 13 de novo) but with eight HCV + recipients (53%, P = 0.02). Consider ing only the French patients, prevalence was 44% vs 12% in the French RT population (P = 0.006). Eight patients had graft rejection after 59 months (five HCV +). In this type I MPGN subgroup, there were two pos itive cr?yoglobulins, two rheumatoid factors and four hypocomplementae mias. In conclusion, there is a clear association between HCV infectio n and the occurrence of type I MPGN in the allograft in renal transpla ntation, with terminal renal failure as an outcome.