Prevalence of hepatitis C virus antibodies in primary glomerulonephritis in Brazil

The association between hepatitis B virus and membranous glomerulonephritis and membranoproliferative glomerulonephritis (MPGN) was first described in 1971. Recently, a similar association between hepatitis C virus (HCV) and glomerulonephritis (CN) has been reported. We investigated the prevalence o f hepatitis C serum antibodies (anti-HCV) in patients with primary GN follo wed up at our Nephrology Outpatient Clinic between March 1993 and November 1995. The diagnosis of primary GN was established after excluding the prese nce of connective tissue disease, diabetes, infectious disease, and maligna ncy. Anti-HCV antibodies were detected by a second-generation enzyme immuno sorbent assay and HCV RNA by polymerase chain reaction. Of 81 patients with primary GN, 24 had membranous glomerulonephritis, 17 MPGN, 15 minimal-chan ge disease, 12 focal-segmental glomerulosclerosis, 9 diffuse proliferative GN, and 4 IgA nephropathy. Anti-HCV were detected in 2 cases (2.5 %), both were HCV RNA positive and had a polyclonal mixed cryoglobulinemia (IgM-IgG) . These 2 cases both came from the group of 17 patients with MPGN. Biochemi cal investigation in these patients revealed persistent elevation of serum aminotransferase activity, and a liver biopsy specimen in 1 of them showed evidence of chronic active hepatitis. We conclude that in our setting the p revalence of anti-HCV among patients with primary GN is low, being higher ( 11.8 %) only if we consider the patients with MPGN as the reference group. Further studies are necessary to clarify this association and to determine appropriate therapy for these patients.