Histological characterization of HCV- associated nephropathy in Egyptian patients with detection of viral particles by PCR in some selected cases

Abstract

Background: HCV infection was found to be associated with variable affections in renal tissue. Indirect role of HCV on renal tissue through circulating cryoglobulins was established in several studies. Although viral particles were detected in renal tissue by several methods including ISH and RT-PCR, the direct role of HCV in pathogenesis of nephropathy still unclear.

Methods: The present study was performed on 50 patients showing both renal affection and HCV seropositivity. Clinical and laboratory data were collected and analysed , renal biopsies were examined and the variable patterns of renal affection were recorded. Also detecting HCV-RNA particles in renal tissue was done in some selected cases using PCR and ISH techniques.

Results: In the present study the mean age of the fifty patients was 47.7 ± 8.8 years and there was male predominance with male:female ratio 2.1:1. The most common clinical presentations were impaired renal functions and nephrotic syndrome. The most common glomerular disease was MPGN with or without cryoglobulinemia, also there was tubulointerstitial affection in the form of tubular atrophy, interstitial inflammation and interstitial fibrosis. There was a direct relation between the degree of tubular atrophy and interstitial fibrosis, also there was a relation between the tubulointerstitial affection and serum creatinine level. Regarding detection of HCV-RNA in the renal tissue, both PCR & ISH were used and gave positive results, however PCR was more accurate as all the selected cases were positive.

Conclusion: This study supports the hypothesis that there is strong relation between HCV infection and renal affection and that HCV­ RNA particles can be detected in renal tissue by using PCR and ISH.