HCV相关肾损伤及其治疗的研究进展

Research advances in hepatitis C virus-related renal injury and its treatment

HCV是一种血源性传播的病毒,是导致肝硬化、肝细胞癌的主要原因之一。大量的流行病学研究证实了HCV感染和肾脏疾病的关系。混合性冷球蛋白血症相关的膜性增生性的肾小球肾炎是最常见的HCV相关性肾脏疾病类型,主要临床表现是肾病或肾炎综合征、蛋白尿、血尿、肾小球滤过率降低等。HCV相关肾脏疾病治疗主要包括抗病毒治疗、B淋巴细胞清除的治疗、非特异的免疫抑制治疗。同时,随着新型抗病毒药物上市,使不能耐受传统方案人群看到了希望。综述了HCV相关肾损伤的流行病学、临床表现、发病机制及治疗等方面的研究进展。

Hepatitis C virus（HCV） is a blood-borne virus transmitted through contact with blood and blood products,and it is a major cause of liver cirrhosis and hepatocellular carcinoma. Many epidemiological studies have confirmed the association between HCV infection and renal disease. Membranoproliferative glomerulonephritis associated with mixed cryoglobulinemia is the most common type of HCV-related renal disease manifesting as nephropathy or nephritic syndrome,proteinuria,hematuria,and reduced glomerular filtration rate. The treatment of HCV-related renal disease includes antiviral therapy,B cell clearance,and non-specific immunosuppressive therapy. At the same time,the launch of new antiviral drugs has brought hope to the patients who cannot tolerate conventional regimens. This article reviews the research advances in epidemiology,clinical manifestations,pathogenesis,and treatment of HCV-related renal injury.