Hepatitis C-related membranoproliferative glomerulonephritis in the era of direct antiviral agents
| العنوان: | Hepatitis C-related membranoproliferative glomerulonephritis in the era of direct antiviral agents |
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| المؤلفون: | Sawsan Fadda, Eman H. Abd Elbary, Mahmoud H Zahran, Ali M Shendi, Walid Ahmed Ragab Abdelhamid |
| المصدر: | Brazilian Journal of Nephrology (2021) Brazilian Journal of Nephrology n.ahead 2021 Jornal Brasileiro de Nefrologia Sociedade Brasileira de Nefrologia (SBN) instacron:SBN Brazilian Journal of Nephrology v.44 n.2 2022 Brazilian Journal of Nephrology, Issue: ahead, Published: 12 FEB 2021 |
| بيانات النشر: | FapUNIFESP (SciELO), 2022. |
| سنة النشر: | 2022 |
| مصطلحات موضوعية: | Virologia, Sustained Virologic Response, Glomerulonephritis, Membranoproliferative, medicine.medical_treatment, Hepatitis C virus, Crioglobulinemia, 030232 urology & nephrology, Hepacivirus, medicine.disease_cause, Antiviral Agents, Mycophenolic acid, Proteinúria, 03 medical and health sciences, Glomerulonephritis, 0302 clinical medicine, Glomerulopathy, Virology, Membranoproliferative glomerulonephritis, medicine, Humans, business.industry, Immunosuppression, General Medicine, Hepatitis C, Mycophenolic Acid, Hepatitis C, Chronic, Ácido Micofenólico, medicine.disease, Cryoglobulinemia, Diseases of the genitourinary system. Urology, Proteinuria, Immune System, 030220 oncology & carcinogenesis, Immunology, Leukocytes, Mononuclear, RC870-923, business, Resposta Viral Sustentada, Sistema Imunitário, medicine.drug |
| الوصف: | Membranoproliferative glomerulonephritis (MPGN) is the most typical Hepatitis C virus (HCV)-associated glomerulopathy, and the available data about the utilization of direct-acting antivirals (DAA) in HCV-associated glomerulonephritis is inadequate. We evaluated the renal and viral response in two cases of HCV-related MPGN; the first caused by cryoglobulinemia while the second was cryoglobulin-negative. Both patients received immunosuppression besides DAA in different regimens. They achieved partial remission but remained immunosuppression-dependent for more than 6 months after DAA despite sustained virological response, which enabled safer but incomplete immunosuppression withdrawal. Both patients were tested for occult HCV in peripheral blood mononuclear cells and found to be negative. Hence, the treatment of HCV-related MPGN ought to be according to the clinical condition and the effects of drug therapy. It is important to consider that renal response can lag behind the virological response. Resumo A glomerulonefrite membranoproliferativa (GNMP) é a glomerulopatia associada ao vírus mais típico da hepatite C (HCV), e os dados disponíveis sobre a utilização de antivirais de ação direta (AAD) na glomerulonefrite associada ao HCV são inadequados. Avaliamos a resposta renal e viral em dois casos de GNMP relacionados ao HCV; o primeiro causado por crioglobulinemia, enquanto o segundo era negativo para crioglobulina. Ambos os pacientes receberam imunossupressão além de AAD em diferentes esquemas terapêuticos. Eles alcançaram remissão parcial, mas permaneceram dependentes da imunossupressão por mais de 6 meses após os AAD, apesar da resposta virológica sustentada, que permitiu a retirada da imunossupressão mais segura, mas incompleta. Ambos os pacientes foram testados para HCV oculto em células mononucleares do sangue periférico e deram resultados negativos. Portanto, o tratamento do GNMP relacionado ao VHC deve ser de acordo com a condição clínica e os efeitos da terapia medicamentosa. É importante considerar que a resposta renal pode ficar aquém da resposta virológica. |
| وصف الملف: | text/html |
| تدمد: | 2175-8239 0101-2800 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::a374b2a2b76b4e80566fec55eab75781 https://doi.org/10.1590/2175-8239-jbn-2020-0148 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....a374b2a2b76b4e80566fec55eab75781 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 21758239 01012800 |
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