Prevalence of glomerulopathies in autopsies of patients infected with the hepatitis C virus

Background. Several reports have shown hepatitis C virus (HCV) infection to be associated with various extrahepatic manifestations, including certain forms of glomerulopathy. The most frequently reported glomerulonephritis in patients infected with HCV is either membranoproliferative glomerulonephritis (MPGN) or cryoglobulinemic glomerulonephritis, and HCV has been directly implicated in their pathogenesis. Other investigators have reported a higher prevalence of HCV infection in patients with membranous glomerulonephritis, IgA nephropathy, and focal segmental glomerulosclerosis (FSGS). However, the prevalence of these glomerulopathies in patients infected with HCV is unknown. Methods: We conducted a 5-year retrospective review to determine prevalence of glomerulopathies in autopsies of patients infected with HCV. The renal histology on the autopsy reports was carefully reviewed for appropriate diagnosis of glomerulonephritis. Results: Of the 114 autopsies of patients infected with HCV during this period, the majority had been incarcerated and had state-mandated autopsies. The mean age of the patients was 46.8 +/- 10 years (+/- SD; range, 19-87). Of the 114 patients, 46 were white, 37 were African American, and 31 were Hispanic. The glomerulopathies seen were 3 MPGN, 2 membranous, 3 HIV-associated nephropathy, I idiopathic FSGS, 1 minimal change glomerulonephritis, and 3 diabetic nephropathy. Conclusion: We conclude that although HCV is reported to be associated with membranoproliferative and membranous glomerulonephritis, their prevalence in these patients is not common.