Focal segmental glomerular sclerosis among patients infected with hepatitis C virus

This study describes the occurence of hepatitis C virus (HCV) infection in the setting of focal segmental glomerular sclerosis (FSGS). All patients wi th the pathologic diagnosis of idiopathic FSGS between 1992 and 1996 at the University of Washington Hospitals were examined using a retrospective coh ort study design. FSGS was determined by renal biopsy in the absence of sec ondary causes. Demographic, laboratory, and outcome data were collected in a standardized fashion. Six patients (50%) were infected with HCV. Patients with HCV infection and FSGS were primarily Black (67%), hypertensive (100% ), had a history of intravenous drug abuse (83%), and had normal liver enzy mes. Those with HCV infection and a history of IVDA appeared clinically and histologically similar to previously described cases of 'heroin nephropath y'. We demonstrate that there is a high prevalence of HCV infection in our population of patients with idiopathic FSGS. Although this may simply refle ct an epiphenomenon, we propose that HCV infection may play a role in the d evelopment of FSGS in a predisposed host.