Lupus-Like Immune Complex-Mediated Glomerulonephritis in Patients With?Hepatitis C Virus Infection Treated With Oral, Interferon-Free, Direct-Acting Antiviral?Therapy

摘要

I t is estimated that between 2.2 and 3.2 million people are infected with hepatitis C virus (HCV) in theUnited States.1 For more than 20 years, the mainstay ofHCV treatment has been interferon (IFN) alfa, anonspecific immunomodulatory antiviral cytokine, andribavirin (RBV). This regimen had limited efficacy andwas poorly tolerated. Because of this, therapy was notwidely deployed and the majority of patients with HCVinfection remained untreated.2 In December 2013,sofosbuvir (SOF), an inhibitor of the HCV NS5B RNApolymerase, was approved by the U.S. Food and DrugAdministration, and thus began an era of all-oral IFNfree HCV therapies. Currently approved direct-actingantiviral (DAA) therapies target 1 of 3 viral proteins,the NS5B polymerase, the NS3/4A protease, or theNS5A protein (Table 1). These agents profoundlyinhibit viral replication and, when used in combination, can produce viral clearance without dependenceon IFN.