Histopathological Pattern of nephropathy in HCV positive patients at Ain Shams Specialized Hospital (A 10-Years retrospective study)

Abstract

Background: More than 170 million people worldwide are chronically infected with the hepatitis C virus (HCV), which is responsible for over 1 million deaths from cirrhosis and primary liver cancers ,Beside chronic liver disease, relevant extra hepatic manifestations of HCV infection include cryoglobulinemia, lymph proliferative disorders, and renal diseases. There is increasing evidence of an association between HCV infection and glomerular disease both in native kidneys and after kidney transplantation. Objective: To high light the prevalence of different clinico pathological findings of nephropathy diagnosed in hepatitis c virus positive patients at Ain shams specialized hospital, based on retrospective analysis of renal biopsies obtained over a 10 years’ period. Material and Methods: All percutaneous renal biopsies for HCV positive patients(proved by detection of HCV Ab and\or Pcr) submitted to pathology and electron microscopy in units of Ain Shams Specialized hospital from January 2004 to December 2014 were included. Prior to the biopsy procedure, clinical examination,pelvi-abdominal ultrasound and laboratory investigation include urine analysis, kidney function test, liver function test and clotting profile. Results : This is a retrospective study from January 2004 to December 2014 and included 81 patients who fulfill the required data, As regard histopathological diagnosis, type 1 membranoproliferative GN in 34 patients(42.0%),there was statistically significant relation between associated disease(Diabetes, AF, SLE, RA) and results of histopathology; renal impairment was significantly associated with type 1membranoproliferative GN and focal segmental glomerulosclerosis, cryoglobulinemia was significantly associated with type 1 membranoproliferative GN and cryoglobulinemic glomerulonephritis while non nephrotic proteinuria was significantly associated with type 1 membranoproliferative GN, and type 2 membranous nephropathy. Key words: Hepatitis C virus(HCV),Nephropathy, Renal biopsy,Membrano proliferative glomerulonephritis, Protinuria