Hepatitis virus-related nephropathies

The extrahepatic manifestations of hepatitis B virus infection include reactive arthritis, vasculitis (panarteritis nodosa) and primary glomerulonephritis (membranous nephropathy, membranoproliferative glomerulonephritis and, less frequently, IgA nephropathy, focal and segmental glomerulosclerosis, minimal change disease, and extracapillary glomerulonephritis). No specific histomorphological patterns have been reported in association with HDV infection. Cryoglobulinemic glomerulonephritis is the only pattern of glomerular involvement unequivocally related to HCV infection. The treatment of HBV-related glomerulopathies is essentially antiviral. Corticosteroids have been proven to be ineffective (except in panarteritis nodosa), while immunosuppressants can lead to exacerbation of HBV infection. The treatment of HCV-related nephritis, especially cryoglobulinemic glomerulonephritis, encompasses various options including both conventional and novel immunomodulatory agents, possibly combined with antiviral therapy.