Hepatitis C virus-associated glomerulonephritis.

Hepatitis C virus (HCV) infection remains a major global health burden. In addition to liver-related morbidity and mortality due to hepatic decompensation and development of hepatocellular carcinoma, extrahepatic manifestations of hepatitis C are frequent. Type I membranoproliferative glomerulonephritis associated with type II cryoglobulinemia is the most frequent association. The pathogenesis of the renal lesions is related to glomerular deposition of immune complexes. International guidelines recommend that patients with HCV-related glomerulopathies should be treated with antiviral therapy in the form of standard or pegylated interferon-α and ribavirin. The recent development of direct-acting antiviral agents that inhibit the various steps of the viral life cycle represents a major milestone for the treatment of chronic HCV infection. Initial reports suggest that they are safe in ESRD subjects. However, data is lacking on their efficacy and safety in HCV-related glomerulonephritis.