Histological Characterization of HCV-Associated Glomerulopathy in Egyptian Patients

Abstract

HCV infection in Egypt has reached epidemic proportion, it is associated with many extra hepatic manifestations. Glomerulonephritis (GN) is one of the most serious ending in renal failure in some cases. Detection of viral genome or particles within the kidneys of HCV-infected patients proved to be difficult. Histological characterization of renal lesions still represents a major challenge. The aim of our work was to describe the histological patterns of HCV-associated nephropathy. Fifty patients--out of 233 presented to Mansoura Urology and Nephrology clinic with manifestations of glomerular disease were screened for HCV antibodies by 3rd generation ELISA test-, those proved positive for HCV antibodies were confirmed by PCR for HCV RNA and were thoroughly investigated regarding clinical, biochemical, histological criteria's of HCV-associated nephropathy. Kidney and liver biopsies were examined by LM and electron microscopy. Histological study of renal biopsies revealed membranoproliferative (MPGN) type 1 to be the commonest lesion encountered (54), followed by focal segmental glomerulosclerosis (FSGS) (24), mesangioproliferative GN (18), membranous nephropathy (MN) (4) in that order. Electron microscopic examinations of renal biopsies were successful in identifying HCV-like particles in frozen renal tissue. HCV-associated glomeruloapthy is a distinct category of glomerulonephritis, by LM it has some peculiar features, we were successful in localization of HCV particles in renal tissues by EM.