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Abstract Introduction: Hepatitis C virus infection is a major blood-borne infection worldwide. HCV infection should be considered as a systemic disorder which is often associated with a number of extrahepatic manifestations such as cryoglobulinemia and Glomerulopathies. Aim of work: review the incidence of kidney involvement in the course of HCV infection and effect of treatment on HCV-associated glomerulopathies. Patient and methods: 1028 Naïve patients aged (18 -75) presented to Samalout centre for HCV treatment will be enrolled in the research after confirmation of HCV infection with HCV RNA real-time PCR. Those patients will be subjected to: Full clinical history, examination and Proteinuria. According to results; patients with +ve proteinurea will further subjected to: Rheumatoid factor, Cryoglobulin and C3, C4. Patients with renal impairment, positive tests arranged for renal biopsy and the biopsy tissue specimens fixed in formalin and embedded in paraffin, examined after staining with hematoxylin and eosin. Patients established with HCV induced glomerulopathy classified into 1) group 1; Glomerulonephritis, in patients with moderate proteinuria, stable renal functions and mild to moderate histological lesions at renal biopsy started DAAs treatment with close monitoring of level of albuminuria, renal functions and HCV RNA – PCR 4 weeks after starting treatment and at end of treatment and 3 month later. 2) group 2; Patients with nephrotic-range proteinuria and/or progressive kidney injury, immunosuppressive therapy with cyclophosphamide (2 mg/kg per day for 2-4 mo), steroid pulses (0.5-1 g/d for 3 d) administered and after stabilization they offered DAAs treatment as group 1. Results: : the prevalence of clinical proteinuria among patients with HCV was 5.6 %, with 3.8 % having mean A/C ratio of 405.68 ± 92.617 and 1.7% has mean A/C ratio of 898.06 ± 996.007 and only 0.3% of patients has mean A/C ratio of 4135.67 ± 1979.529. Results confirmed that MPGN represents 41.37%. the sustained virological response among patients with proteinuria was 93.1% with no significant difference between different DAAs regimens. the response rate of proteinuria (either complete or partial) after DAAs was 72.4 % as compared to 27.6 % patients who showed non-response, this is confirmed by the significant difference between pre and post treatment A/C ration among patients with proteinuria (P-Value = 0.002). Conclusions: Eradication of the virus is, undoubtedly, a key target in the therapeutic approach to HCV-related extrahepatic features. |