Hepatitis C--associated glomerular disease in liver transplant recipients.

C. L. Davis, D. R. Gretch, J. D. Perkins, A. W. Harris, M. H. Wener, C. E. Alpers, R. Lesniewski, W. Lee, C. dela Rosa, R. J. Johnson

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Hepatitis C virus (HCV) infection may be associated with extrahepatic illness including renal disease. We investigated the clinical and virological characteristics of three patients who developed a mesangial proliferative and sclerosing glomerulopathy alone or in association with membranoproliferative glomerulonephritis after liver transplantation for end-stage liver disease secondary to HCV infection. Using polymerase chain reaction technology and the IgM RIBA assay, viral load, genotype and IgM antibody response to HCV in the setting of glomerulonephritis was evaluated. Within 1 year of transplantation, the patients showed decreased renal function, proteinuria and recurrent hepatitis C liver disease. Likewise, HCV viral load increased following transplantation, whereas the viral genotypes remained unchanged. Although the first patient presented with classic type II cryoglobulinemia in association with glomerulonephritis, the second patient developed an IgM directed specifically against the hepatitis C core antigen. The third patient developed a low-titered IgM directed against the hepatitis C core antigen with rheumatoid factor activity but without cryoglobulinemia. All of the patients show IgM in glomerular capillary walls by biopsy. One patient has shown a clinical response to interferon (IFN) alfa-2b therapy without evidence of hepatic allograft rejection. The second and third patients have not responded to IFN or developed hepatic rejection. This study suggests that HCV-associated glomerulonephritis may complicate liver transplantation in conjunction with the production of increased amounts of IgM of variable specificity. The posttransplant setting may provide a unique situation in which to investigate the specific requirements for the onset of renal disease.

Original languageEnglish (US)
Pages (from-to)166-175
Number of pages10
JournalLiver transplantation and surgery : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
Volume1
Issue number3
StatePublished - May 1995

Fingerprint

Hepatitis C
Liver Diseases
Immunoglobulin M
Hepacivirus
Hepatitis C Antigens
Glomerulonephritis
Cryoglobulinemia
interferon alfa-2b
Virus Diseases
Viral Load
Kidney
Liver Transplantation
Transplantation
Genotype
Membranoproliferative Glomerulonephritis
End Stage Liver Disease
Transplant Recipients
Rheumatoid Factor
Liver
Proteinuria

ASJC Scopus subject areas

  • Hepatology
  • Surgery

Cite this

Hepatitis C--associated glomerular disease in liver transplant recipients. / Davis, C. L.; Gretch, D. R.; Perkins, J. D.; Harris, A. W.; Wener, M. H.; Alpers, C. E.; Lesniewski, R.; Lee, W.; dela Rosa, C.; Johnson, R. J.

In: Liver transplantation and surgery : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society, Vol. 1, No. 3, 05.1995, p. 166-175.

Research output: Contribution to journalArticle

Davis, C. L. ; Gretch, D. R. ; Perkins, J. D. ; Harris, A. W. ; Wener, M. H. ; Alpers, C. E. ; Lesniewski, R. ; Lee, W. ; dela Rosa, C. ; Johnson, R. J. / Hepatitis C--associated glomerular disease in liver transplant recipients. In: Liver transplantation and surgery : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society. 1995 ; Vol. 1, No. 3. pp. 166-175.
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