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Abstract: FR-PO1129

Collapsing Glomerulopathy in Hepatitis C Virus Positive Patients: A Retrospective Autopsy Study of 95 Cases

Session Information

Category: Glomerular Diseases

  • 1203 Glomerular Diseases: Clinical, Outcomes, and Trials

Authors

  • Lal, Yasir, UTMB, Galveston, Texas, United States
  • Kassem, Hania, UTMB, Galveston, Texas, United States
  • Ukudeyeva, Aijan T., UTMB, Galveston, Texas, United States
  • Charles, Derald Derek, UTMB, Galveston, Texas, United States
  • Etienne, Samantha Valerie, UTMB, Galveston, Texas, United States
  • Fischer, Wayne G., UTMB, Galveston, Texas, United States
  • Afrouzian, Marjan, UTMB, Galveston, Texas, United States
Background

Patients (pts) with hepatitis C virus (HCV) infection may present with a variety of glomerular diseases, however Collapsing glomerulopathy (CG) is an uncommon presentation. In most pts, this lesion is associated with human immunodeficiency virus (HIV) infection while in a small number of cases, CG is considered to be idiopathic. The aim of this study was to determine the prevalence of CG in HCV-positive, HIV-negative (HCV+ HIV-) pts, using autopsy material to explore the significance of this association through clinical, pathological and laboratory correlation.

Methods

We performed a retrospective autopsy study, examining the renal parenchyma of 95 HCV+ pts. Pts with positive or unknown HIV status or those who had exposure to interferon (IFN) therapy were excluded. Thereafter, the presence of CG (test group) or absence of CG (control group) was recorded using hematoxylin and eosin, periodic acid-Schiff and Jones stains. Clinical and laboratory correlation included evaluation of demographics, terminal serum creatinine, HCV serology, viral load (VL), dipstick proteinuria, serum albumin (Alb), and cause of death. A t-test (pooled variances) was used for comparison of continuous variables such as age, BMI, HCV VL and Alb. Comparison of categorical variables such as gender, race, and HCV genotype was based on contingency analysis.

Results

Forty cases were excluded based on HIV status and IFN exposure. CG was identified in 19/55 pts (34.5 %). There was no significant difference in age, race, BMI, Alb, creatinine, proteinuria or cause of death among the two groups. HCV VL was higher in the test group but the difference was not statistically significant.

Conclusion

To our knowledge, this is the largest autopsy study describing the occurrence of CG in HCV+ HIV- pts. Our results demonstrate an association and prevalence of CG in HCV infection that have not been previously established. Therefore, CG should be considered in HCV+ HIV- pts who present with renal failure and proteinuria. Further studies are needed to elucidate prevalence and pathogenesis of CG in these pts.