Stehman-Breen C, Alpers C E, Couser W G, Willson R, Johnson R J
Division of Nephrology, University of Washington Medical Center, Seattle 98195, USA.
Clin Nephrol. 1995 Sep;44(3):141-7.
Hepatitis C virus infection has been associated with a variety of extrahepatic disorders. We report four patients with membranous glomerulonephritis and hepatitis C virus infection. In contrast to patients previously reported with HCV infection and membranoproliferative glomerulonephritis, these patients have normal or minimally reduced complement levels and no evidence of rheumatoid factor or cryoglobulinemia. A liver biopsy in one patient was consistent with chronic active hepatitis although liver enzymes were only minimally elevated and coagulation studies normal. Three patients were treated with alpha-interferon with some success. Treatment with alpha-interferon may have a beneficial effect in reducing proteinuria and improving liver function and may be related to the ability of interferon to suppress viremia. Future studies need to focus on clarifying the role of the virus in causing glomerular disease and improving dosing strategies for alpha-interferon. Randomized, controlled studies need to be performed to determine whether the beneficial effect of alpha interferon is significant, and if so, if it is superior to conventional therapies.
丙型肝炎病毒感染与多种肝外疾病有关。我们报告了4例膜性肾小球肾炎合并丙型肝炎病毒感染的患者。与先前报道的丙型肝炎病毒感染合并膜增生性肾小球肾炎的患者不同，这些患者的补体水平正常或仅轻度降低，且无类风湿因子或冷球蛋白血症的证据。1例患者的肝活检结果符合慢性活动性肝炎，尽管其肝酶仅轻度升高且凝血研究正常。3例患者接受了α干扰素治疗并取得了一定成功。α干扰素治疗可能对减少蛋白尿和改善肝功能有有益作用，这可能与干扰素抑制病毒血症的能力有关。未来的研究需要集中在阐明病毒在引起肾小球疾病中的作用以及改进α干扰素的给药策略。需要进行随机对照研究以确定α干扰素的有益作用是否显著，如果是，它是否优于传统疗法。
