The Clinico-pathologic Features of Hepatitis B Virus-associated Glomerulonephritis

摘要

The frequency of hepatitis B Surface antigen (HBsAg) was studied in the sera of 311 patients with various forms of primary glomerulonephritis and 43 patients with lupus nephritis. HBs antigenaemia was detected in 69 of the 311 patients (22 per cent) with primary glomerulonephritis and this prevalence of HBaAg carrier was significantly higher than that in the general population (p<0. 001). These patients had no clinical or biochemical findings to suggest acute or chronical liver disease. A higher HBs antigenaemia carrier rate was not observed in patients with lupus nephritis. Three glomerulopathological entities, membranous nephropathy. IgA nephropathy, and mesangial proliferative glomerulonephrities, were found to be associated with a higher prevalence of HBs antigenaemia compared with the general population (p<0. 001). Glomerular deposits of HBsAg and/or hepatitics core antigen (HBcAg) were detected in 41, 61, and 60 per cent of renal biopsy specimens from patients with membranous nephropathy, Iga nephropathy, and mesangial proliferative glomerulonephritis associated with persistent HBs antigenaemia respectively. During the mean study period of 40 months (range 12–180), 14 per cent of these patients with hepatitis-associated glomerulonephrities developed progressive renal failure, althrough none required maintenanece dialysis. Our study suggests that hepatitis B virus antigenaemia may play a significant role in the developement of specific forms of glomerulonephritis and that these hepatities B virus-associated glomerulonephritides can run an indolent but relentless progressive clinical cours