Kupin WL – This paper focuses on viral–associated GN in relation to hepatitis C and HIV. Researchers observe that with the advent of direct–acting antivirals for hepatitis C (HCV) and more effective combined antiretroviral therapy for HIV, successful remission and even regression of glomerular lesions can be achieved if initiated at an early stage.

Methods

• Authors determine various pathogenic mechanisms of viral (either hepatitis C (HCV) or HIV)-induced glomerular injury, including direct viral infection of renal tissue and the development of circulating immune complexes composed of viral antigens that deposit along the glomerular basement membrane.

Results

• As per epidemiologic, approximately 25%–30% of all HIV patients are coinfected with HCV and 5%–10% of all HCV patients are coinfected with HIV.
• Differential diagnosis often become challenging when glomerular disease occurs in this dual-infected population; researchers thus suggest the necessity for the clinician to be aware of the clinical presentation, laboratory workup, and pathophysiology behind the development of renal disease for both HCV and HIV.
• Both of these viruses can be categorized under the new classification of infection-associated GN as opposed to being listed as causes of postinfectious GN as has previously been applied to them.
• Neither of these viruses result in renal injury after a latent period of controlled and inactive viremia.
• HCV- and HIV-associated glomerular diseases geneses seem to have a total dependence on the presence of active viral replication to sustain renal injury so the renal disease cannot be listed under “postinfectious” GN.