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Saudi Journal of Kidney Diseases and Transplantation
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LETTER TO THE EDITOR Table of Contents   
Year : 2010  |  Volume : 21  |  Issue : 5  |  Page : 964-966
Associations of various histological morphologies of renal involvement in hepatitis B infection: Analysis of 118 subjects


1 Baqiyatallah Research Center for Gastroenterology and Liver Diseases, Baqiyatallah University of Medical Sciences, Tehran, Iran
2 Baqiyatallah Research Center for Gastroenterology and Liver Diseases, Baqiyatallah University of Medical Sciences, Tehran; Dr. Taheri Medical Research Group, Tehran, P.O. Box 14155-6437, 1435915371, Iran

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Date of Web Publication31-Aug-2010
 

How to cite this article:
Khedmat H, Taheri S. Associations of various histological morphologies of renal involvement in hepatitis B infection: Analysis of 118 subjects. Saudi J Kidney Dis Transpl 2010;21:964-6

How to cite this URL:
Khedmat H, Taheri S. Associations of various histological morphologies of renal involvement in hepatitis B infection: Analysis of 118 subjects. Saudi J Kidney Dis Transpl [serial online] 2010 [cited 2019 Dec 16];21:964-6. Available from: http://www.sjkdt.org/text.asp?2010/21/5/964/68907
To the Editor,

HBV-related nephropathy is one of the HBV infection extra-hepatic manifestations. The asso­ciation between chronic hepatitis B virus (HBV) infection and glomerular diseases was first des­cribed by Combes et al in 1971, [1] and since then several morphological patterns for glomerular lesions have been described including mem­branous nephropathy, membranoproliferative glomerulonephritis, mesangial proliferative glo­merulonephritis, minimal change disease, IgA nephropathy, and focal segmental glomerulo­sclerosis. [2],[3] However, because of the rarity of the condition, almost all data existing on this issue in the literature has limited patient po­pulations making it difficult to analyze various associations of morphological patterns of HBV related nephropathies. In two previous studies, we reviewed nephropathies associated with the HBV infection and efficacy of current treat­ment strategies. [4],[5] In this study, however, we conducted a literature review to collect data from different studies to be able to make ana­lyses for any associations of histological le­sions of HBV related nephropathy.

Overall 118 subjects from ten studies [6],[7],[8],[9],[10],[11],[12],[13],[14],[15] were included into analysis. All HBs Ag negative patients had IgA nephropathy while only 43% of HBs Ag positive patients had IgA nephro­pathy (P< 0.001). Development of IgA neph­ropathy in HBV infected patients was signi­ficantly associated with a negative result for HBe Ag (9% vs. 77%, P< 00.001) while mem­branous nephropathy was significantly repre­sented with HBe Ag positivity (70% vs. 20, P< 0.001). IgA nephropathy was more frequently seen among adult patients (67% vs. 22%, P= 0.013); but in children, membranous nephro­pathy was more likely to occur (56% vs. 16%, P= 0.014), and; membranous nephropathy was in general significantly associated with renal failure (P= 0.021).

[Table 1] summarizes associations of different types of renal lesions with all other variables. Patients with IgA nephropathy had signifi­cantly lower AST (26.7 ± 5.8 vs. 58.6 ± 32.5 IU/L P= 0.001) and ALT (25.2 ± 8.0 vs. 85.1 ± 94.7 IU/l, P= 0.019) levels compared to other histological features.

We conclude that viral antigen type contri­butes to the disparities between various mor­phological renal lesions in HBV related neph­ropathies. Membranous nephropathy represen­ted the highest renal failure rate; and needs more intensive management strategies.
Table 1 :Associations of various types of HBV associated nephropathies with all other variables.

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   References Top

1.Combes B, Stastny P, Shorey J, et al. Glo­merulonephritis with deposition of Australia antigen antibody complexes in glomerular basement membrane. Lancet 1971;2:234-6.  Back to cited text no. 1  [PUBMED]    
2.Ching-Yuang L. Clinical features and natural course of HBV-related glomerulopathy in chil­dren. Kidney Int 1991;40(suppl 35):46-53.  Back to cited text no. 2      
3.Coovadia HM, Adhikari M, Moodley M: He­patitis B 's' and 'e' antigen carriage in child­hood nephrotic syndrome predicts membra­nous glomerulonephritis. Ann Trop Paediatr 1993;13:79-82.  Back to cited text no. 3      
4.Khedmat H, Taheri S. Hepatitis B Virus-asso­ciated Glomerulonephritis. Hepat Mon 2009;9 (2):137-45.  Back to cited text no. 4      
5.Khedmat H, Taheri S. Hepatitis B Virus-asso­ciated Nephropathy: An International Data Ana-lysis. Iran J Kidney Dis. 2010 Apr;4(2): 101-5.  Back to cited text no. 5      
6.Tang S, Lai FM, Lui YH, et al. Lamivudine in hepatitis B-associated membranous nephro­pathy. Kidney Int 2005;68(4):1750-8.  Back to cited text no. 6      
7.Panomsak S, Lewsuwan S, Eiam-Ong S, Kan­janabuch T. Hepatitis-B virus-associated neph­ropathies in adults: a clinical study in Thailand. J Med Assoc Thai 2006;89(Suppl 2):S151-6.  Back to cited text no. 7      
8.Kusakabe A, Tanaka Y, Kurbanov F, et al. Virological features of hepatitis B virus-asso­ciated nephropathy in Japan. J Med Virol 2007;79(9): 1305-11.  Back to cited text no. 8      
9.Khaira A, Upadhyay BK, Sharma A, et al. Hepatitis B virus associated focal and seg­mental glomerular sclerosis: report of two cases and re-view of literature. Clin Exp Nephrol 2009;13 (4):373-7.  Back to cited text no. 9      
10.Wang NS, Wu ZL, Zhang YE, Guo MY, Liao LT. Role of hepatitis B virus infection in pathogenesis of IgA nephropathy. World J Gastroenterol 2003;9(9):2004-8.  Back to cited text no. 10      
11.Wang NS, Wu ZL, Zhang YE, Liao LT. Exis­tence and significance of hepatitis B virus DNA in kidneys of IgA nephropathy. World J Gastroenterol 2005;11(5):712-6.  Back to cited text no. 11      
12.Izzedine H, Massard J, Poynard T, Deray G. Lamivudine and HBV-associated nephropathy. Nephrol Dial Transplant 2006;21(3):828-9.  Back to cited text no. 12      
13.Gonzalo A, Mampaso F, Barcena R, Gallego N, Ortuno J. Membranous nephropathy asso­ciated with hepatitis B virus infection: long­term clinical and histological outcome. Nephrol Dial Transplant 1999;14(2):416-8.  Back to cited text no. 13      
14.Connor FL, Rosenberg AR, Kennedy SE, Bohane TD. HBV associated nephrotic synd­rome: resolution with oral lamivudine. Arch Dis Child 2003;88(5):446-9.  Back to cited text no. 14      
15.URL< http://bhj.org/journal/2001_4301_jan/none original_128. htm> ACCESSED May 6, 2009.  Back to cited text no. 15      

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Correspondence Address:
Hossein Khedmat
Baqiyatallah Research Center for Gastroenterology and Liver Diseases, Baqiyatallah University of Medical Sciences, Tehran
Iran
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PMID: 20814146

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