Hepatitis B Virus-Related Glomerulonephritis with Positive and Negative Serum HBsAg: Different Clinicopathologic Characteristics of Two Clinical Subtypes

Abstract

Introduction The clinicopathologic characteristics of Hepatitis B virus-associated glomerulonephritis (HBV-GN) patients with different serum HBsAg are not well known. This study aims to investigate the characteristics and treatments between HBV-GN patients with positive and negative serum HBsAg. Methods A retrospective review of patients with renal biopsies in Guangdong Provincial People’s Hospital from 2005 to 2018 was performed. Clinicopathological data, treatments and remission of proteinuria were collected and compared between HBsAg+ and HBsAg- group. Results A total of 101 HBV-GN were recruited. Serum HBsAg+ and HBsAg- patients accounted for 62.4% and 37.6%, respectively. HBsAg+ group had poor kidney and liver functions. Pathological data showed the percentage of membranous nephropathy in HBsAg- group is significantly higher than that of HBsAg+ group (60.3% HBsAg+ vs 89.5% HBsAg-, P <0.05). Chronic renal tubular/interstitial injury was more prevalent in HBsAg+ group (16.9% HBsAg+ vs 2.6% HBsAg-, P <0.05). The deposition sites of immune complexes were significant different between the two groups. In addition, more HBsAg+ patients were given anti-HBV and less were given corticosteroid or immunosuppressants for treatment than that of HBsAg- patients. Percentages of clinical remission were increasing in both HBsAg+ and HBsAg- patients from 1, 3, 6 months to 1 year (18.75%, 45.2%, 67.8%, 82.4% vs 24.4%, 41.2%, 62.8%, 59.3%). The differences of remission betwen two groups were not significant ( P >0.05). Conclusion The clinicopathological characteristics and treatments of HBV-GN with serum HBsAg+ and HBsAg- were distinct, which indicated that the pathogenesis might be different and specific treatments were needed for HBV-GN patients with different serum HBsAg.

Diagnostic value of renal biopsy in anti-phospholipase A2 receptor antibody-positive patients with proteinuria in China

“…We found similar treatment remission rates for HBV-MN and PMN in our previous study 24 . Moreover, HBV-GN remission was similar in both serum HBsAg + and HBsAg − patients 25 . Thus, HBsAg/HBcAg staining may be a crucial test in Chinese patients with MN.…”

Hepatitis B Virus Infection and Extra-Hepatic Manifestations: A Systemic Disease

“…Several differences have been observed between children and adults regarding the mode of presentation (Table 2). Renal disease may occur in 3%-5% of patients with chronic HBV infection (60). A large Chinese study showed that over time the prevalence of HBV-associated GN has decreased (61).…”

“…Although HBV-associated GN decreased over the past decade thanks to HBV vaccine campaign, it remains an important issue in endemic countries for HBV infection as China (72). A study including 101 HBV-GN showed that HBsAg status correlated with different clinicopathological characteristics and the deposition sites of IC (60).…”