Treatment of membranoproliferative glomerulonephritis associated with hepatitis C virus infection

Objective Interferon has been used as a new therapeutic agent for glomerulo nephritis since a manifest relationship between membranoproliferative glome rulonephritis (MPGN) and hepatitis C virus (HCV) infection was documented. However, several side effects and rebound phenomenon have been significant problems. We retrospectively evaluated the therapeutic effect and safety of the standard treatment with steroids and/or immunosuppressive agents for M PGN patients with an HCV infection, Methods Remission and renal survival rates as well as clinical and histolog ical data were compared between MPGN groups with or without an HCV infectio n. In addition, the hepatic function was followed-up after the treatment. Patients The subjects were 42 biopsy proven MPGN patients. Seven were posit ive for an HCV infection. Secondary causes of MPGN excluding an HCV infecti on were omitted. Most patients were treated with steroids and/or immunosupp ressive agents. Results The mean age of the MPGN patients with an HCV infection was signifi cantly higher than that of those without an HCV infection. The renal functi on and the interstitial change of the former group were significantly worse than those of the latter. Nevertheless, remission and renal survival rates were not significantly different between the two groups. None in the HCV p ositive MPGN group showed an impairment of hepatic function during the clin ical course. However, 2 subjects died from severe pneumonia during the trea tment. Conclusion The standard treatment with steroids and! or immunosuppressive a gents did not reveal a statistical difference in the therapeutic efficacy b etween MPGN patients with or without an HCV infection, However, some in the former group showed a poor prognosis.