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Clinicopathological characteristics and prognosis of hepatitis B associated membranous nephropathy and idiopathic membranous nephropathy complicated with hepatitis B virus infection. Sci Rep 2021; 11:18407. [PMID: 34526634 PMCID: PMC8443741 DOI: 10.1038/s41598-021-98010-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 09/01/2021] [Indexed: 11/22/2022] Open
Abstract
The main objective of this study is to analyze the clinical and pathological features and prognosis of patients with Hepatitis B associated membranous nephropathy (HBV-MN) and idiopathic membranous nephropathy (IMN) complicated with hepatitis B virus (HBV) infection. This study will provide more basis for diagnosis and prognosis evaluation. A total of 50 patients with HBV-MN were included in this study. 56 IMN patients complicated with HBV infection diagnosed during the same period formed the control group. Parameters including blood routine, urine routine and plasma levels of albumin (ALB), serum creatinine (SCR), blood urea nitrogen (BUN), urea acid (UA), total cholesterol (T-CHO), triglycerides (TG), complement C3 and C4, glutamic pyruvic transaminase (ALT), glutamic pyruvic transaminase (AST), 24-h urinary protein quantification (24 h-TP), renal phospholipase A2 receptor (PLA2R) and HBV related markers during the hospitalization and outpatient follow-up study period were collected for all the patients. The proportion of male patients was high in both groups. The average age of the HBV-MN group was 37.2 ± 14.187 years old, it was younger compared with the IMN group (P = 0.003). Nephrotic syndrome was the major clinical manifestation among patients. There was no significant difference between the two groups in the levels of anemia, microscopic hematuria, renal dysfunction, liver dysfunction, liver cirrhosis. The level of serum C3 and C4 in the HBV-MN group was lower compared with the IMN group (P = 0.002, P = 0.014). In the HBV-MN group, serum HBV markers were negative in 6 (12%) patients, 4 patients (8%) were positive for PLA2R in serum, and 5 patients (10%) were positive for PLA2R in renal tissue. Stronger IgG1 and C1q and weaker IgG4 staining were found in HBV-MN group renal tissues (P = 0.003, P = 0.025, and P = 0.001, respectively). There were no statistical differences compared with serum and renal PLA2R between HBV-MN and IMN groups (P = 0.098, P = 0.109). During the 1-year follow-up, there was no significant difference in complete remission rate between the two groups (P = 0.7739). Renal biopsy is crucial to diagnose HBV-MN. IgG subtypes in the HBV-MN group were mainly IgG1 deposition, while those in IMN complicated with HBV infection group were mainly IgG4 deposition. When HBV-associated antigen and PLA2R are present in renal tissue, lower level of serum C3 and C4, high intensity of renal C1q and IgG1 is more supportive of HBV-MN. The positive of PLA2R in serum and renal tissue in differentiating HBV from IMN complicated with HBV infection remains to be discussed.
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Zhuang Y, Liu B, Yu Y, Guan T, Zheng Z, Chen A. Severity of Intrarenal Arterial Lesions Can Predict the Clinical Prognosis of Hepatitis B Virus-Associated Glomerulonephritis: A Retrospective Study. KIDNEY DISEASES 2020; 7:67-77. [PMID: 33614735 DOI: 10.1159/000509088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 05/31/2020] [Indexed: 11/19/2022]
Abstract
Background Intrarenal arterial lesions (IALs) have been studied in immunoglobulin A nephropathy and lupus nephritis, but this has not been reported in hepatitis B virus-associated glomerulonephritis (HBV-GN). This study aims to investigate the prevalence and the role of IALs in HBV-GN. Methods IALs were examined in kidney biopsy specimens from 205 patients with HBV-GN retrospectively. The severity of IALs and tubular interstitial lesions was scored semi-quantitatively. The severity of IALs was divided into 4 groups on the basis of ILA score, which were no IALs (Score 0), mild IALs (Score 1-2), moderate IALs (Score 3-4), and severe IALs (Score 5-10) groups. Survival analysis was performed using the Kaplan-Meier method between the severity of IALs and clinical events (doubling of serum creatinine [SCr], ESRD, and death due to the kidney disease). Results Among 205 patients with HBV-GN, 143 (69.8%) had IALs in their kidney biopsy specimens. IALs were mild in 28 (19.6%) patients, moderate in 101 (70.6%) patients, and severe in 14 (9.8%) patients. The severity of IALs was associated with high blood pressure (BP), high SCr, and severe tubulointerstitial injuries. The average follow-up time of these 205 HBV-GN patients was 94.2 ± 47.1 months, in which 46 cases had clinical event. The proportions of clinical events in no IAL, mild IAL, moderate IAL, and severe IAL groups were 9.7, 14.3, 25.7, and 71.4%, respectively. Event-free survival of patient in IAL group was significantly lower than that in the no IAL group (p = 0.000). Multivariate cox regression analysis indicated SCr (1.011, 1.007-1.016), hypertension (1.767, 1.004-3.108), and IAL (2.194, 1.062-4.530) were independent risk factors for clinical events after adjustment for age and gender. Event-free clinical survival in moderate and severe IAL groups was significantly lower than that in the no IAL group (p = 0.0111 and p = 0.0001, respectively). Besides, event-free renal survival in severe IAL group was significantly lower than that in moderate IAL group (p = 0.009). Multivariate cox regression analysis showed that the more severe the IALs, the higher the risk of the clinical event, with a hazard ratio of 2.284 for moderate IALs (1.085-4.907) and 3.315 for severe IALs (1.296-8.482). Conclusions Severity of IALs is associated with high BP, reduced renal function, and poor clinical prognosis in HBV-GN patients.
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Affiliation(s)
- Yongze Zhuang
- Department of Nephrology, 900 Hospital of the Joint Logistics Team, PLA, Fuzhou General Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Bo Liu
- Department of Nephrology, 900 Hospital of the Joint Logistics Team, PLA, Fuzhou General Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Yinghao Yu
- Department of Pathology, 900 Hospital of the Joint Logistics Team, PLA, Fuzhou General Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Tianjun Guan
- Department of Nephrology, Zhongshan Hospital Affiliated to Xiamen University, Xiamen, China
| | - Zhiyong Zheng
- Department of Pathology, 900 Hospital of the Joint Logistics Team, PLA, Fuzhou General Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Anqun Chen
- Department of Nephrology, Zhongshan Hospital Affiliated to Xiamen University, Xiamen, China
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Huang CW, Lin CH, Chuang YW, Yang SS, Lee TY, Yeh HZ, Chang CS, Lu IT. Association of hepatitis B virus infection and glomerulonephritis in a HBV-endemic area: A population-based study. ADVANCES IN DIGESTIVE MEDICINE 2018. [DOI: 10.1002/aid2.13092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Chiao-Wei Huang
- Division of Gastroenterology & Hepatology, Department of Internal Medicine; Taichung Veterans General Hospital; Taichung Taiwan
| | - Cheng-Heng Lin
- Department of Medical Research; Taichung Veterans General Hospital; Taichung Taiwan
| | - Ya-Wen Chuang
- Division of Nephrology, Department of Internal Medicine; Taichung Veterans General Hospital; Taichung Taiwan
| | - Sheng-Shun Yang
- Division of Gastroenterology & Hepatology, Department of Internal Medicine; Taichung Veterans General Hospital; Taichung Taiwan
- Faculty of Medicine, College of Medicine; National Yang-Ming University; Taipei Taiwan
| | - Teng-Yu Lee
- Division of Gastroenterology & Hepatology, Department of Internal Medicine; Taichung Veterans General Hospital; Taichung Taiwan
- School of Medicine; Chung Shan Medical University; Taichung Taiwan
| | - Hong-Zen Yeh
- Division of Gastroenterology & Hepatology, Department of Internal Medicine; Taichung Veterans General Hospital; Taichung Taiwan
- Faculty of Medicine, College of Medicine; National Yang-Ming University; Taipei Taiwan
| | - Chi-Sen Chang
- Division of Gastroenterology & Hepatology, Department of Internal Medicine; Taichung Veterans General Hospital; Taichung Taiwan
- School of Medicine; Chung Shan Medical University; Taichung Taiwan
| | - I-Ta Lu
- Division of Gastroenterology & Hepatology, Department of Internal Medicine; Taichung Veterans General Hospital; Taichung Taiwan
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Xu Md F, Wang Md C, Shi Md X, Hou Md J, Guo Md X, Gao Md P. Resolution of HBV infection occurs sooner than recovery of renal disease in adult serum HBsAg-negative HBV-associated glomerulonephritis. J Med Virol 2018; 90:1503-1507. [PMID: 29718537 DOI: 10.1002/jmv.25211] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Accepted: 04/27/2018] [Indexed: 11/11/2022]
Abstract
Most cases of hepatitis B virus-associated glomerulonephritis (HBV-GN) occur in children and present with serum HBsAg positivity. Few studies have investigated adult patients with HBV-GN who are serum HBsAg-negative. This study aimed to determine the clinical and pathological features of adult patients with HBV-GN who are serum hepatitis B surface antigen (HBsAg)-negative. Clinical, pathologic, and laboratory findings were collected and analyzed in a cohort of 27 adult patients with HBV-GN who were serum HBsAg-negative upon diagnosis. The study population included mostly men of middle age (40-59 years). Clinically, patients presented with nephrotic syndrome. Serum immunoglobulin G levels were low, whereas serum immunoglobulin M, immunoglobulin A, complement C3 (C3), and complement C4 (C4) levels as well as liver and renal function tests were normal in most or all patients. Among the 27 patients, 21 tested positive for HBV antibodies. Membranous nephropathy was the dominant pathological form on kidney biopsy. In addition, only a few patients showed a "full house" staining pattern and renal immune deposit of complement C1q (C1q). Serum HBsAg-negative HBV-GN may represent a late stage of HBV infection. We recommend routine testing for HBV markers on renal biopsy in regions where HBV is prevalent, even when tests for serum HBV markers are negative.
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Affiliation(s)
- Fang Xu Md
- Department of Hepatology, The First Hospital of Jilin University, Changchun, China
| | - Chong Wang Md
- Department of Hepatology, The First Hospital of Jilin University, Changchun, China
| | - Xiaoju Shi Md
- Department of Hepatic Surgery, The First Hospital of Jilin University, Changchun, China
| | - Jie Hou Md
- Department of Urology, The First Hospital of Jilin University, Changchun, China
| | - Xiaolin Guo Md
- Department of Hepatology, The First Hospital of Jilin University, Changchun, China
| | - Pujun Gao Md
- Department of Hepatology, The First Hospital of Jilin University, Changchun, China
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Berchtold L, Zanetta G, Dahan K, Mihout F, Peltier J, Guerrot D, Brochériou I, Ronco P, Debiec H. Efficacy and Safety of Rituximab in Hepatitis B Virus-Associated PLA2R-Positive Membranous Nephropathy. Kidney Int Rep 2017; 3:486-491. [PMID: 29725654 PMCID: PMC5932116 DOI: 10.1016/j.ekir.2017.09.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Affiliation(s)
- Lena Berchtold
- Inserm, UMR_S 1155, Paris, France.,Sorbonne Universités, Université Pierre et Marie Curie University of Paris 06, Paris, France.,Department of Internal Medicine, Service of Internal Medicine, Geneva University Hospital, Geneva, Switzerland (current address)
| | - Gilbert Zanetta
- Department of Nephrology, Dijon University Hospital, Dijon, France
| | - Karine Dahan
- Department of Nephrology and Dialysis, Assistance Publique-Hôpitaux de Paris, Tenon Hospital, Paris, France
| | - Fabrice Mihout
- Department of Nephrology and Dialysis, Assistance Publique-Hôpitaux de Paris, Tenon Hospital, Paris, France
| | - Julie Peltier
- Department of Renal Intensive Care Unit and Kidney Transplantation, AP-HP, Tenon Hospital, Paris, France
| | - Dominique Guerrot
- Department of Nephrology, Rouen University Hospital, Normandie University, Université de Rouen, Inserm U1096, Rouen, France
| | - Isabelle Brochériou
- Department of Pathology, Assistance Publique-Hôpitaux de Paris, Tenon Hospital, Paris, France
| | - Pierre Ronco
- Inserm, UMR_S 1155, Paris, France.,Sorbonne Universités, Université Pierre et Marie Curie University of Paris 06, Paris, France.,Department of Nephrology and Dialysis, Assistance Publique-Hôpitaux de Paris, Tenon Hospital, Paris, France
| | - Hanna Debiec
- Inserm, UMR_S 1155, Paris, France.,Sorbonne Universités, Université Pierre et Marie Curie University of Paris 06, Paris, France
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A Meta-Analysis of Antiviral Therapy for Hepatitis B Virus-Associated Membranous Nephropathy. PLoS One 2016; 11:e0160437. [PMID: 27598699 PMCID: PMC5012684 DOI: 10.1371/journal.pone.0160437] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Accepted: 07/19/2016] [Indexed: 12/20/2022] Open
Abstract
Hepatitis B virus-associated membranous nephropathy (HBV-MN) is the most common renal extra-hepatic manifestation in patients with chronic HBV infection. In September 2015, we searched the MEDLINE, EMBASE, and CENTRAL databases, and the reference lists of retrieved articles, to identify relevant studies. Descriptions of antiviral drugs used to treat HBV-MN were included in our review. Two authors independently screened all relevant articles, extracted data, and assessed the risk of bias. Nine hundred and fifty-four papers have been considered after electronic and manual searching, only five relevant studies were identified. Complete remission (OR = 26.87, 95% CI: 8.06 to 89.52), total remission (OR = 10.31, 95% CI: 3.59 to 29.63) of proteinuria and HBeAg clearance (OR = 20.91, 95% CI: 6.90 to 63.39) increased significantly after antiviral therapy. No significant differences were seen between interferon and nucleoside analog treatments. Our study found that antiviral therapy was an effective treatment in HBV-MN patients; interferon and nucleoside analogs were equally effective at causing proteinuria remission and HBeAg clearance.
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Kong XL, Ma XJ, Su H, Xu DM. Relationship between occult hepatitis B virus infection and chronic kidney disease in a Chinese population-based cohort. Chronic Dis Transl Med 2016; 2:55-60. [PMID: 29063026 PMCID: PMC5643595 DOI: 10.1016/j.cdtm.2016.07.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE Previous studies have revealed inconsistent results regarding the association between occult hepatitis B virus (HBV) infection and chronic kidney disease (CKD). Therefore, we conducted a prospective cohort study to evaluate the association between occult HBV infection and CKD. METHODS A total of 4329 adults, aged 46.2 ± 13.7 years, without CKD at baseline were enrolled while undergoing physical examinations. Occult HBV infection was defined as seropositivity for antibody to HBV core antigen. CKD was defined as decreased estimated glomerular filtration rate (eGFR < 60 ml·min-1·1.73 m-2) or presence of proteinuria ≥1+, assessed using a repeated dipstick method. eGFR was computed using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. RESULTS The prevalence of occult HBV infection was 8.1% (352/4329). During 5 years of follow-up, 165 patients (3.8%) developed CKD. Univariate Logistic regression analysis showed that occult HBV infection was positively associated with decreased eGFR, with an odds ratio (OR) of 2.15 (95% confidence interval (CI): 1.05-4.11). In contrast, occult HBV infection was not associated with either proteinuria or CKD (P > 0.05). After adjustment for potential confounders in the multivariate Logistic regression analysis, age, hypertension, diabetes, and the highest quartile of uric acid were associated with CKD, with ORs of 1.04 (95% CI: 1.02-1.05), 2.1 (95% CI: 1.46-3.01), 2.02 (95% CI: 1.36-2.99), and 1.86 (95% CI: 1.17-2.95), respectively. However, occult HBV infection was not associated with CKD, with an OR of 1.12 (95% CI: 0.65-1.95). CONCLUSIONS This study did not find an association between occult HBV infection and CKD. However, high-risk patients infected with HBV should still be targeted for monitoring for the development of CKD.
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Affiliation(s)
- Xiang-Lei Kong
- Department of Nephrology, Qianfoshan Hospital, Shandong University, No.16766, Jingshi Road, Jinan, China
| | - Xiao-Jing Ma
- Department of Health Examination Center, Qianfoshan Hospital, Shandong University, No.16766, Jingshi Road, Jinan, China
| | - Hong Su
- Department of Nephrology, Qianfoshan Hospital, Shandong University, No.16766, Jingshi Road, Jinan, China
| | - Dong-Mei Xu
- Department of Nephrology, Qianfoshan Hospital, Shandong University, No.16766, Jingshi Road, Jinan, China
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Sun YH, Lei XY, Sai YP, Chen JH, Sun YC, Gao X. Relationship between genotypes and clinical manifestation, pathology, and cccDNA in Chinese children with hepatitis B virus-associated glomerulonephritis. World J Pediatr 2016; 12:347-352. [PMID: 27059747 DOI: 10.1007/s12519-016-0015-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Accepted: 12/11/2014] [Indexed: 12/30/2022]
Abstract
BACKGROUND Hepatitis B virus-associated glomerulonephritis (HBV-GN) is one of the extrahepatic manifestations after HBV infection, which would cause great clinical harm to people. The present study was undertaken to investigate the HBV-GN genotypes and its clinical relevance in Chinese children. METHODS A total of 41 HBV-infected children diagnosed with HBV-GN were enrolled in the study. All patients underwent liver and kidney biopsy. The genotypes and cccDNA were detected in their serum samples to analyze the relationship between HBV genotypes and clinical characteristics, cccDNA, and pathology. RESULTS Among the 41 children with HBV-GN, 29 (70.7%) had genotype C, 10 (24.4%) had genotype B, 2 (4.9%) had genotype B/C, and none of them had genotype non-B/C. Most children had genotypes B or C; moreover, the genotype C was the most frequent one. The incidence of hematuria and albuminuria, reduction in complement C3, increase in serum alanine aminotransferase levels and renal insufficiency in the children with genotype C were significantly higher than those in the children with genotype B (P<0.05); however, there was no statistically significant difference in hypertension and hepatomegaly (P>0.05). The frequency of HBV cccDNA positive in the genotype C group was significantly higher than that in the genotype B group (72.4% vs. 30.0%, P<0.05). No difference was observed in hepatic inflammation grades and stages of fibrosis between the two groups (P>0.05). CONCLUSIONS Genotype C was the most frequent genotype in the described group of patients with HBV-GN, and the liver and kidney damage indicators were more likely to occur in patients with genotype C.
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Affiliation(s)
- Yong-Hong Sun
- Department of Pediatrics, People's Hospital of Gansu Province, Lanzhou, Gansu, China
| | - Xiao-Yan Lei
- Department of Pediatrics, People's Hospital of Gansu Province, Lanzhou, Gansu, China.
| | - Yi-Pa Sai
- Department of Pediatrics, People's Hospital of Gansu Province, Lanzhou, Gansu, China
| | - Jun-Hui Chen
- Department of Pediatrics, People's Hospital of Gansu Province, Lanzhou, Gansu, China
| | - Yuan-Chun Sun
- Department of Pediatrics, People's Hospital of Gansu Province, Lanzhou, Gansu, China
| | - Xia Gao
- Department of Pediatrics, People's Hospital of Gansu Province, Lanzhou, Gansu, China
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Jung CW, Park KT, Jun H, Kim SY, Kim SJ, Kim MG, Jo SK, Cho W, Kim HK. A Single-Center Experience of Overseas Kidney Transplant for Immunologically High-Risk Patients. EXP CLIN TRANSPLANT 2015; 13 Suppl 1:251-5. [DOI: 10.6002/ect.mesot2014.p59] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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10
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The need for kidney transplantation in low- and middle-income countries in 2012: an epidemiological perspective. Transplantation 2015; 99:476-81. [PMID: 25680089 DOI: 10.1097/tp.0000000000000657] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Epidemiological and demographic transitions are shifting the burden of modifiable risk factors for chronic and end-stage kidney disease to low- and middle-income countries (LMIC). This shifting burden of disease--combined with economic transitions and health system reforms--has led to the rapid growth of dialysis populations in LMIC including Malaysia, Tunisia, Turkey, Chile, Mexico, and Uruguay. Yet, compared to 1.5 million on dialysis in LMIC, only approximately 33,000 kidney transplants were performed in 2012. Reasons include health system factors (personnel, infrastructure, system coordination, and financing) and cultural factors (public and professional attitudes and the legal environment). The size of the dialysis populations, however, is generally a poor indicator of the potential need for kidney transplantation in LMIC. Population needs for kidney transplantation should instead be assessed based on the epidemiology of the actual underlying burden of disease (both treated and untreated), and the costs and benefits of treatment as well as prevention strategies relative to existing service provision. Here, we review current data on the global burden of end-stage kidney disease and the distribution of major risk factors, and compare this to access to kidney transplantation in 2012.
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Liu T, Yang S, Yue Z, Kuang Y, Guan W, Sun L. Clinical and pathological characteristics of 5 children with HBV surface antigen (HBsAg)-negative hepatitis B virus-associated glomerulonephritis. J Clin Virol 2015; 66:1-5. [PMID: 25866326 DOI: 10.1016/j.jcv.2015.02.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Revised: 02/11/2015] [Accepted: 02/19/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND Hepatitis B virus-associated glomerulonephritis (HBV-GN) mainly occurs in children. Patients with HBV-GN are frequently positive for serum HBV surface antigen (HBsAg), but they are rarely negative. OBJECTIVE To explore the clinical and pathological characteristics of patients with HBV-GN who are serum HBsAg negative. STUDY DESIGN Five children with HBV-GN who are negative for HBsAg were included in this study. Their clinical and pathological characteristics were collected and analyzed. RESULTS All 5 children presented with different levels of proteinuria and microscopic hematuria. Renal biopsies showed membranous nephropathy accompanied by HBsAg and/or HBcAg deposits in glomeruli in all of the children. Steroids and/or other immunosuppressants were administered in all cases without antiviral therapy during the early stages of treatment. Two children achieved complete remission but relapsed after the drugs were tapered down. The other 3 children were initially non-responsive but achieved remission after lamivudine was added. CONCLUSIONS Treatment of HBsAg-negative HBV-GN patients with immunosuppressants alone could not achieve satisfactory effects. Antiviral treatment is effective and may be necessary in this type of patient.
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Affiliation(s)
- Ting Liu
- Children's Kidney Disease Center, Department of Pediatrics, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Shicong Yang
- Department of Pathology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zhihui Yue
- Children's Kidney Disease Center, Department of Pediatrics, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yu Kuang
- Department of Clinical Laboratory, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Weiming Guan
- Department of Pathology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Liangzhong Sun
- Children's Kidney Disease Center, Department of Pediatrics, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
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Lei X, Gao X, Yang J, Sun Y, Sai Y, You W, Yuan H. The genotype C could play a key role in hepatitis B virus associated nephritis among the northwest Chinese children. Eur J Intern Med 2013; 24:835-8. [PMID: 23988262 DOI: 10.1016/j.ejim.2013.07.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Revised: 06/04/2013] [Accepted: 07/16/2013] [Indexed: 02/08/2023]
Abstract
BACKGROUND Hepatitis B virus-associated glomerulonephritis (HBV-GN) is a kind of immune complex-induced glomerulonephritis. The present study was designed to determine whether Hepatitis B virus (HBV) genotype is associated with glomerulonephritis in north-west Chinese children. METHODS A total of 296 HBV-infected patients were enrolled in this study. The serum of patients was subjected to DNA extraction and the HBV genotypes were determined by PCR. RESULTS The results showed that genotype C (49%) was predominant within the subjects, compared to HBV/B (38.5%), B/C recombinant (7.4%) and none B/C (5.1%). The serum tests showed that the changes of Complement 3 (C3) and alanine amino transferase (ALT) levels in the genotype C patients were significantly greater than those in the genotype B patients. The frequency of genotype C in HBV-GN patients was higher than that in non HBV-GN patients (χ2 value=30.239, P<0.001). But, it was not associated with renal dysfunction. Furthermore, The genotype C was associated with high HBV-DNA load (82.9% vs 17.1%, P<0.001), which is seen more frequently in the HBV-GN children (86.3% vs 13.3%, P=0.004). CONCLUSIONS The genotype C may play a role in HBV-GN children, via favoring HBV replication.
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Affiliation(s)
- Xiaoyan Lei
- Pediatric Department, Gansu Provincial Hospital, Lanzhou City, 730000, China.
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13
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Lu HZ, Zhou JH. Hepatitis B virus X protein up-regulates tumor necrosis factor-α expression in cultured mesangial cells via ERKs and NF-κB pathways. Asian Pac J Trop Biomed 2013; 3:217-22. [PMID: 23620841 PMCID: PMC3631753 DOI: 10.1016/s2221-1691(13)60053-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2012] [Accepted: 01/27/2013] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVE To investigate the effects of hepatitis B virus (HBV) X protein (HBx) on the expression of tumor necrosis factor-α (TNF-α) in glomerular mesangial cells (GMCs) and the underlying intracellular signal pathways. METHODS The plasmid pCI-neo-X that carries the X gene of hepatitis B virus was transfected into cultured GMCs. HBx expression in the transfected GMCs was assessed by Western-blot. TNF-α protein and mRNA were assessed by ELISA and semi-quantitative RT-PCR, respectively. Three kinase inhibitors-U0126, an inhibitor of extracellular signal-regulated kinases (ERKs); lactacystin, an inhibitor of nuclear factor-κB (NF-κB); and SB203580, a selective inhibitor of p38 MAP kinase (p38 MAPK) were used to determine which intracellular signal pathways may underlie the action of HBx on TNF-α expression in transfected GMCs. RESULTS A significant increase in HBx expression in pCI-neo-X transfected GMCs was detected at 36 h and 48 h, which was not affected by any of those kinase inhibitors mentioned above. A similar increase in the expression of both TNF-α protein and mRNA was also observed at 36 h and 48 h, which was significantly decreased in the presence of U0126 or lactacytin, but not SB203580. CONCLUSIONS HBx upregulates TNF-α expression in cultured GMCs, possibly through ERKs and NF-κB pathway, but not p38 MAPK pathway.
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Affiliation(s)
- Hong-Zhu Lu
- Deptartment of Pediatrics, Clinical Medical College, Yangtze University, Jingzhou 434000, China
| | - Jian-Hua Zhou
- Deptartment of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
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