Renal disease secondary to chronic hepatitis C virus (HCV) infection is infrequent but often life threatening and difficult to treat. Management is directed towards eradication of the virus. Combination therapy with interferon α or pegylated interferon α and ribavirin has been used successfully to induce recovery from membranoproliferative glomerulonephritis (MPGN), cryoglobulinaemia, and vasculitis, if viral clearance is achieved.^1–8 Unfortunately, symptoms recur in the absence of a sustained virological response. Long term suppressive maintenance therapy may be an alternative, but has not been reported previously.

History

A 46 year old man with HCV genotype 4 was referred to our institution for evaluation of chronic HCV infection (CHC) and nephrotic syndrome. Initial investigations revealed proteinuria (+++) and haematuria (+++) with dysmorphic red cells on urinalysis. Haemoglobin level (Hb) was 136 g/l, …