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接受直接抗病毒治疗获得持续病毒学应答后新发丙型肝炎病毒相关性肾小球肾炎

New-onset hepatitis C virus-associated glomerulonephritis following sustained virologic response with direct-acting antiviral therapy
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作者信息

Ghosn Muriel, Palmer Matthew B, Najem Catherine E, Haddad Danny, Merkel Peter A, Hogan Jonathan J

出版信息

Clin Nephrol. 2017 May;87 (2017)(5):261-266. doi: 10.5414/CN109019.

Abstract

Glomerulonephritis (GN) is an important extra-hepatic manifestation of infection with hepatitis C virus (HCV). HCV-associated GN occurs due to HCV-induced lymphoproliferation, leading to the generation of pathogenic immune complexes, including complexes containing cryoglobulins. The management of HCV-associated extra-hepatic disease is focused on viral eradication, with direct-acting antiviral agents leading to high rates of sustained virologic remission. There have been a few reports of relapsing cryoglobulinemic vasculitis after sustained virologic remission was achieved with interferon-based therapies. This report presents two cases of new-onset HCV-associated GN that occurred after sustained virologic response was achieved with direct-acting antiviral (DAA) therapy.
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摘要

肾小球肾炎(GN)是丙型肝炎病毒(HCV)感染的一种重要肝外表现。HCV相关的GN是由于HCV诱导的淋巴细胞增殖,导致致病性免疫复合物的产生,包括含有冷球蛋白的复合物。HCV相关肝外疾病的治疗重点是根除病毒,直接作用抗病毒药物可导致高比例的持续病毒学缓解。有少数报告称,基于干扰素的治疗实现持续病毒学缓解后,冷球蛋白血症性血管炎复发。本报告介绍了两例在直接作用抗病毒(DAA)治疗实现持续病毒学应答后发生的新发HCV相关GN病例。

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