| Title | Influence of antiviral therapy in hepatitis C virus-associated cryoglobulinemic MPGN. | | Author(s) | Alric L, Plaisier E, Thébault S, Péron JM, Rostaing L, Pourrat J, Ronco P, Piette JC, Cacoub P | | Institution | Service de Médecine Interne, Pavillon Dieulafoy, CHU Purpan, Toulouse, France. alric.l@chu-toulouse.fr | | Source | Am J Kidney Dis 2004 Apr; 43(4):617-23. | | MeSH | Aged
Antiviral Agents
Cryoglobulinemia
Drug Therapy, Combination
Female
Glomerulonephritis, Membranoproliferative
Hepatitis C
Humans
Interferon Alfa-2a
Interferon Alfa-2b
Interferons
Male
Middle Aged
Polyethylene Glycols
Ribavirin
Treatment Outcome
| | Abstract | BACKGROUND: The influence of hepatitis C virus (HCV) treatment on the course of HCV cryoglobulinemic membranoproliferative glomerulonephritis (MPGN) is controversial.
METHODS: Twenty-five patients with nephrotic-range proteinuria, mixed cryoglobulinemia, MPGN proved by renal biopsy, and HCV infection were studied for their response to antiviral treatment.
RESULTS: After first-line treatment with prednisone, furosemide, or plasmapheresis, antiviral therapy with standard or pegylated interferon alfa and ribavirin was introduced in 18 patients. These patients were compared with 7 patients who did not receive antiviral treatment. Mean duration of antiviral treatment was 18 +/- 10 months, with a follow-up of at least 6 months after treatment withdrawal. HCV RNA clearance (sustained virological response) was achieved in 12 of 18 patients. Compared with values before antiviral therapy, a decrease in proteinuria was observed in sustained virological responders at the end of combination therapy, as well as at the end of follow-up (mean, 2.85 +/- 2.2 [SD] versus 1 +/- 1.4 and 0.4 +/- 0.8 g/d, respectively; P < 0.05). In sustained virological responders, cryoglobulin levels at the end of treatment (0.29 +/- 0.4 g/L) and end of follow-up (0.25 +/- 0.4 g/L) were decreased (P < 0.05) compared with pretreatment values (1.38 +/- 2.2 g/L). Conversely, no changes in serum cryoglobulinemia levels were observed in nonresponders or controls. Serum creatinine levels remained stable in the 18 patients with antiviral therapy, regardless of response to treatment.
CONCLUSION: Anti-HCV treatment improved HCV-associated cryoglobulinemic glomerulonephritis. | | Language | eng | | Pub Type(s) | Clinical Trial
Journal Article
| | PubMed ID | 15042538 |
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