Digestive Diseases and Sciences

, Volume 59, Issue 3, pp 691–695 | Cite as

De Novo Membrano-Proliferative Nephritis Following Interferon Therapy for Chronic Hepatitis C (Case Study and Literature Review)

  • Fabrizio Fabrizi
  • Alessio Aghemo
  • Gabriella Moroni
  • Patrizia Passerini
  • Roberta D’Ambrosio
  • Paul Martin
  • Piergiorgio Messa
Case Report


HCV infects approximately 2–3 % of the global population and is a leading cause of end-stage liver disease and hepatocellular carcinoma. Antiviral treatment with pegylated interferon and ribavirin eradicates HCV in many patients, while 40–90 % of patients on pegylated IFN plus ribavirin have sustained viral clearance [1]. However, IFN-based therapy is limited by frequent and, at times, serious adverse effects which represent an important barrier to treatment delivery. In clinical trials, approximately 10–15 % of patients discontinue peg-IFN and ribavirin therapy due to adverse effects, but, in clinical practice, the rate of treatment interruption is probably higher. Combined antiviral therapy (conventional or pegylated IFN plus ribavirin) impacts most, if not all, organ systems. According to the KULDS Group, the rate of treatment discontinuation was 8.7 % (n = 250) in a total of 2,871 Japanese patients who had chronic HCV treated with peg-IFN α-2b and RBV [1].

Given the...


Hepatitis C Membrano-proliferative glomerulonephritis Interferon Ribavirin 



This work was supported in part by the grant “Project Glomerulonephritis”; in memory of Pippo Neglia.

Conflict of interest



  1. 1.
    Ogawa E, Furusyo N, Kajiwara E, et al. Evaluation of the adverse effect of premature discontinuation of pegylated interferon α-2b and ribavirin treatment for chronic hepatitis C virus infection: results from the Kyushu University Liver Disease Study [KULDS] Group. J Gastroenterol Hepatol. 2012;27:1233–1240.PubMedCrossRefGoogle Scholar
  2. 2.
    Johnson R, Gretch D, Couser W, et al. Hepatitis C virus-associated glomerulonephritis. Effects of α-interferon therapy. Kidney Int. 1994;46:1700–1704.PubMedCrossRefGoogle Scholar
  3. 3.
    Kidney Disease: Improving Global Outcomes. KDIGO clinical practice guidelines for the prevention, diagnosis, evaluation, and treatment of hepatitis C in chronic kidney disease. Kidney Int. 2008; 73: S1–S99.Google Scholar
  4. 4.
    Cattran D. Interferon therapy: a double-edged sword? Am J Kidney Dis. 1999;33:1174–1176.PubMedCrossRefGoogle Scholar
  5. 5.
    Dusheiko G. Side effects of alpha interferon in chronic hepatitis C. Hepatology. 1997;26:S112–S121.CrossRefGoogle Scholar
  6. 6.
    Ohta S, Yokoyama H, Wada T, et al. Exacerbation of glomerulonephritis in subjects with chronic hepatitis C virus infection after interferon therapy. Am J Kidney Dis. 1999;33:1040–1048.PubMedCrossRefGoogle Scholar
  7. 7.
    Roithinger F, Allinger S, Kirchgatterer A, et al. A lethal course of chronic hepatitis C, glomerulonephritis, and pulmonary vasculitis unresponsive to interferon treatment. Am J Gastroenterol. 1995;90:1006–1009.PubMedGoogle Scholar
  8. 8.
    Coroneos E, Petrusevska G, Varghese F, Truong L. Focal segmental glomerulosclerosis with acute renal failure associated with α-interferon therapy. Am J Kidney Dis. 1996;28:888–892.PubMedCrossRefGoogle Scholar
  9. 9.
    Horino T, Kuriyama S, Tomonari H, et al. Renal damage in a chronic active hepatitis C patient receiving interferon-alpha therapy. Nihon Jinzo Gakkai Shi. 1998;40:48–53.PubMedGoogle Scholar
  10. 10.
    Endo M, Ohi H, Fujita T, Ohsawa I, Kanmatsuse K, Yamaguchi Y. Appearance of nephrotic syndrome following interferon-α therapy in a patients with hepatitis B virus and hepatitis C virus coinfection. Am J Nephrol. 1998;18:439–443.PubMedCrossRefGoogle Scholar
  11. 11.
    Stein D, Ahmed A, Sunkhara V, Khalbuss W. Collapsing focal segmental glomerulosclerosis with recovery of renal function: an uncommon complication of interferon therapy for hepatitis C. Dig Dis Sci. 2001;46:530–535.PubMedCrossRefGoogle Scholar
  12. 12.
    Nishimura S, Miura H, Yamada H, Shinoda T, Kitamura S, Miura Y. Acute onset of nephrotic syndrome during interferon-α treatment for chronic active hepatitis C. J Gastroenterol. 2002;37:854–858.PubMedCrossRefGoogle Scholar
  13. 13.
    Willson R. Nephrotoxicity of interferon alpha-ribavirin therapy for chronic hepatitis C. J Clin Gastroenterol. 2002;35:89–92.PubMedCrossRefGoogle Scholar
  14. 14.
    Dizer U, Beker C, Yavuz I, Ortatatli M, Ozguven V, Pahsa A. Minimal change disease in a patient receiving IFN-α therapy for chronic hepatitis C virus infection. J Interferon Cytokine Res. 2003;23:51–54.PubMedCrossRefGoogle Scholar
  15. 15.
    Suresh R, Suryati Y, Merican I. Interferon induced glomerular disease in a patient with chronic hepatitis C. Med J Malays. 2003;58:594–596.Google Scholar
  16. 16.
    Fisher M, Rossini M, Simmons E, Harris R, Moeckel G, Zent R. A woman with chronic hepatitis C infection and nephrotic syndrome who developed multiple renal lesions after interferon alpha therapy. Am J Kidney Dis. 2004;44:567–573.PubMedCrossRefGoogle Scholar
  17. 17.
    Gordon A, Menahem S, Mitchell J, Jenkins P, Dowlings J, Roberts S. Combination pegylated interferon and ribavirin therapy precipitating acute renal failure and exacerbating IgA nephropathy. Nephrol Dial Transpl. 2004;19:2155–2159.CrossRefGoogle Scholar
  18. 18.
    Couto A, Faria L, Ribeiro D, de Paula F, de Melo Couto O, de Abreu Ferrari T. Life-threatening thrombocytopenia and nephrotic syndrome due to focal segmental glomerulosclerosis associated with pegylated interferon alpha-2b and ribavirin treatment for hepatitis C. Liver Int. 2006;26:1294–1297.CrossRefGoogle Scholar
  19. 19.
    Tovar J, Buti M, Segarra A, Majò J, Esteban R. De novo nephrotic syndrome following pegylated interferon alfa 2b/ribavirin therapy for chronic hepatitis C infection. Int Urol Nephrol. 2008;40:539–541.PubMedCrossRefGoogle Scholar
  20. 20.
    Kanungo S, Tamirisa S, Gopalakrishnan R, Salinas-Madrigal L, Bastani B. Collapsing glomerulopathy as a complication of interferon therapy for hepatitis C infection. Int Urol Nephrol. 2010;42:219–222.PubMedCrossRefGoogle Scholar
  21. 21.
    Markowitz G, Nasr S, Stokes M, D’Agati V. Treatment with IFN-α, -β or -γ is associated with collapsing focal segmental glomerulosclerosis. Clin J Am Soc Nephrol. 2010;5:607–615.PubMedCrossRefGoogle Scholar
  22. 22.
    Tsai M, Chen J, Fang Y, Yang A, Chang C. Membranous nephropathy induced by pegylated interferon α-2a therapy for chronic viral hepatitis B. Clin Nephrol. 2012;77:496–500.PubMedCrossRefGoogle Scholar
  23. 23.
    Lai K, Wei C, Tan L, et al. Overexpression of interleukin-13 induces minimal-change-like nephropathy in rats. J Am Soc Nephrol. 2007;18:1476–1485.PubMedCrossRefGoogle Scholar
  24. 24.
    Gresser I. Interferon: an unfolding tale. J Interferon Cytokine Res. 2007;27:447–452.PubMedCrossRefGoogle Scholar
  25. 25.
    Kimmel P, Abraham A, Phillips T. Membranoproliferative glomerulonephritis in a patient treated with interferon-α for human immunodeficiency virus infection. Am J Kidney Dis. 1994;24:858–863.PubMedGoogle Scholar
  26. 26.
    Yokoyama H, Takaeda M, Wada T, et al. Intraglomerular expression of MHC-class II and Ki-67 antigens and serum γ-interferon levels in IgA nephropathy. Nephron. 1992;62:169–175.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Fabrizio Fabrizi
    • 1
  • Alessio Aghemo
    • 2
  • Gabriella Moroni
    • 1
  • Patrizia Passerini
    • 1
  • Roberta D’Ambrosio
    • 2
  • Paul Martin
    • 3
  • Piergiorgio Messa
    • 1
  1. 1.Division of NephrologyMaggiore Hospital, IRCCS FoundationMilanItaly
  2. 2.Division of Digestive DiseasesMaggiore Hospital, IRCCS FoundationMilanItaly
  3. 3.Division of Hepatology, School of MedicineUniversity of MiamiCoral GablesUSA

Personalised recommendations