HEPATITIS-C VIRUS-ASSOCIATED MEMBRANOUS GLOMERULONEPHRITIS

Hepatitis C virus infection has been associated with a variety of extr ahepatic disorders. We report four patients with membranous glomerulon ephritis and hepatitis C virus infection. In contrast to patients prev iously reported with HCV infection and membranoproliferative glomerulo nephritis, these patients have normal or minimally reduced complement levels and no evidence of rheumatoid factor or cryoglobulinemia. A liv er biopsy in one patient was consistent with chronic active hepatitis although liver enzymes were only minimally elevated and coagulation st udies normal. Three patients were treated with alpha-interferon with s ome success. Treatment with alpha-interferon may have a beneficial eff ect in reducing proteinuria and improving liver function and may be re lated to the ability of interferon to suppress viremia. Future studies need to focus on clarifying the role of the virus in causing glomerul ar disease and improving dosing strategies for alpha-interferon. Rando mized, controlled studies need to be performed to determine whether th e beneficial effect of alpha interferon is significant, and if so, if it is superior to conventional therapies.