APPEARANCE OF NEPHROTIC SYNDROME FOLLOWING INTERFERON-ALPHA THERAPY IN A PATIENT WITH HEPATITIS-B VIRUS AND HEPATITIS-C VIRUS COINFECTION

A 59-year-old woman with hepatitis B surface antigen (HBsAg) and hepat itis C viral (HCV) antibody presented with proteinuria and hematuria. The patient was treated with interferon-alpha (INF-alpha) because plas ma aminotransferase levels had been elevated and a liver biopsy had sh owed chronic active hepatitis. Her urinary protein excretion decreased as liver function normalized and her serum HCV-RNA was negative durin g treatment. Eleven weeks after completion of INF-alpha treatment, she suddenly presented with nephrotic-range proteinuria, although an impr ovement in the hepatic function was maintained. Renal pathologic findi ngs were consistent with membranous glomerulonephritis (MGN), and HBsA g was detected in the glomeruli but not HCV. After treatment with pred nisolone, her 24-hour protein excretion was below 0.7 g/day, To our kn owledge this is the first report on hepatitis B virus MGN with nephrot ic syndrome following IFN-alpha therapy for HCV. This suggests that tr eatment with INF-alpha might affect the immune processes and may be as sociated with the pathogenic mechanism in this patient.