Lamivudine in hepatitis B-associated membranous nephropathy

Abstract

HBV-related MN leads to ESRD in a significant proportion of patients before the advent of antiviral therapy. Lamivudine treatment improves renal outcome in HBV carriers with MN and evidence of liver disease.

A case of anti-GBM glomerulonephritis superimposed on HBV-associated membranous nephropathy

“…However, the incidence of lamivudine-resistant HBV mutant strain is as high as 24 % in 1 year and 53 % in 3 years [35]. In addition, recurrence of proteinuria after cessation of lamivudine is another problem [3,36]. On the other hand, entecavir is more preferable in long-term use because of the lower incidence of drug-resistant mutation, which is reported as 1.2 % over 5 years [37].…”

“…Recently, lamivudine treatment showed a significant decrease in proteinuria and HBV DNA clearance in a year. Cumulative 3-year renal survival was 100 % [3]. However, the incidence of lamivudine-resistant HBV mutant strain is as high as 24 % in 1 year and 53 % in 3 years [35].…”

“…Anti-hepatitis C virus (HCV) and anti-human immunodeficiency virus (HIV) antibody tests were negative, but hepatitis B surface antigen (HBsAg) and hepatitis B e-antibody (HBeAb) were positive (often called 'inactive carrier phase') and HBV DNA [by real-time polymerase chain reaction (PCR)] was detectable (2.7 log copies/ml). Urinalysis revealed urinary protein excretion of about 1.8 g/24 h (a spot protein-to-creatinine ratio of 2.9 g/g creatinine), 3 Further serological study showed that anti-nuclear antibody (ANA) (nuclear membrane-staining pattern) was 40-fold positive. Anti-GBM antibody (the corresponding antigen to which this anti-GBM antibody reacts is the noncollagenous NC1 domain of the a3 chain of type IV collagen) exceeded 300 EU (normal range \10 EU), while myeloperoxidase-antineutrophil cytoplasmic antibody (MPO-ANCA), proteinase-3 (PR3)-ANCA, anti-DNA antibody, and cryoglobulin were not present.…”

“…Although the pathogenesis of this association is unclear, immune complex deposition has been implicated [1]. Antiviral treatment with interferonalpha (IFN-a) and lamivudine has been reported to be beneficial [2,3]. In recent years, entecavir has been used as an antiviral treatment for chronic hepatitis B patients.…”

Efficacy of adefovir dipivoxil combined with a corticosteroid in 38 cases of nephrotic syndrome induced by hepatitis B virus-associated glomerulonephritis

“…Lamivudine, a type of cytosine nucleoside analogue, can effectively suppress RNA reverse transcriptase. A study Adefovir dipivoxil combined with a corticosteroid for HBV-GN 1405 by Tang et al 5 showed that 10 patients who were positive for HBsAg and membranous nephropathy, which was confirmed by renal biopsy, presented with a nephrotic syndrome and underwent treatment with lamivudine. The complete remission rates of 40% and 60% were attained in the 6th and 12th months, respectively; but the widespread application of lamivudine was limited in clinics due to its high tolerance and low HBeAg-negative rate.…”