HBV Hepatitis and Related Renal Nephropathies: Pathogenesis and Treatment
Main Article Content
Keywords
antiviral treatment, HBcAg, HBeAg, HBsAg, hepatitis B-associated glomerulonephritis
Abstract
The extrahepatic manifestations of hepatitis B virus (HBV) infection include reactive arthritis, vasculitis (panarteritisnodosa), and primary glomerulonephritis (membranous nephropathy, membranoproliferative glomerulonephritis, and, less frequently, IgA nephropathy, focal and segmental glomerulosclerosis, and minimal change disease). No specific histomorphological patterns have been reported in association with HBV infection. The treatment of HBV-related glomerulopathies is essentially antiviral. Peginterferon and nucleos(t)ide drugs are the treatment of choice. Corticosteroids have been proved to be ineffective (except in panarteritisnodosa), while immunosuppressants can lead to exacerbation of HBV infection.
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8. Pyrsopoulos NT, Reddy KR. Extrahepatic manifestations of chronic viral hepatitis. Curr Gastroenterol Rep. 2001 Feb;3(1):71–8. http://dx.doi.org/10.1007/s11894-001-0044-1
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10. Chen L, Wu C, Fan X, Gao J, Yin H, Wang T, et al. Replication and infectivity of hepatitis B virus in HBV-related glomerulonephritis. Int J Infect Dis. 2009 May;13(3):394–8. http://dx.doi.org/10.1016/j.ijid.2008.08.014
11. Ozawa T, Levisohn P, Orsini E, McIntosh RM. Acute immune complex disease associated with hepatitis. Etiopathogenic and immunopathologic studies of the renal lesion. Arch Pathol Lab Med. 1976 Sep;100(9):484–6.
12. Takekoshi Y, Tochimaru H, Nagata Y, Itami N. Immunopathogenetic mechanisms of hepatitis B virus-related glomerulopathy. Kidney Int Suppl. 1991 Dec;35:S34–S9.
13. Johnson RJ, Couser WG. Hepatitis B infection and renal disease: Clinical, immunopathogenetic and therapeutic considerations. Kidney Int. 1990 Feb;37(2):663–76. http://dx.doi.org/10.1038/ki.1990.32
14. Gregorek H, Jung H, U?anowicz G, Madali?ski K. Immune complexes in sera of children with HBV-mediated glomerulonephritis. Arch Immunol Ther Exp (Warsz). 1986;34(1):73–83.
15. Nangaku M, Couser WG. Mechanisms of immune-deposit formation and the mediation of immune renal injury. Clin Exp Nephrol. 2005 Sep;9(3):183–91. http://dx.doi.org/10.1007/s10157-005-0357-8
16. Ren J, Wang L, Chen Z, Ma ZM, Zhu HG, Yang DL, et al. Gene expression profile of transgenic mouse kidney reveals pathogenesis of hepatitis B virus-associated nephropathy. J Med Virol. 2006 May;78(5):551–60. http://dx.doi.org/10.1002/jmv.20575
17. He XY, Fang LJ, Zhang YE, Sheng FY, Zhang XR, Guo MY. In situ hybridization of hepatitis B DNA in hepatitis B-associated glomerulonephritis. Pediatr Nephrol. 1998 Feb;12(2):117–20. http://dx.doi.org/10.1007/s004670050417
18. Diao Z, Ding J, Yin C, Wang L, Liu W. Purified hepatitis B virus induces human mesangial cell proliferation and extracellular matrix expression in vitro. Virol J. 2013 Oct 4;10:300–4. http://dx.doi.org/10.1186/1743-422X-10-300
19. Bhimma R, Hammond MG, Coovadia HM, Adhikari M, Connolly CA. HLA class I and II in black children with hepatitis B virus-associated membranous nephropathy. Kidney Int. 2002 Apr;61(4):1510–15. http://dx.doi.org/10.1046/j.1523-1755.2002.00287.x
20. Park MH, Song EY, Ahn C, Oh KH, Yang J, Kang SJ, et al. Two subtypes of hepatitis B virus-associated glomerulonephritis are associated with different HLA-DR2 alleles in Koreans. Tissue Antigens. 2003 Dec;62(6):505–11. http://dx.doi.org/10.1046/j.1399-0039.2003.00141.x
21. Hui D, Yan X, Wei J, Ruixia M, Guangju G. Significance of mutations in hepatitis B virus X gene for the pathogenesis of HB-associated glomerulonephritis. Acta Virol. 2014;58(3):278–81. http://dx.doi.org/10.4149/av_2014_03_278
22. Bhimma R, Coovadia HM. Hepatitis B virus-associated nephropathy. Am J Nephrol. 2004 Mar–Apr;24(2):198–211. http://dx.doi.org/10.1159/000077065
23. Liu XR, Shen Y, Yang YH. Membranous glomerulopathy associated with hepatitis B infection. J Paediatr (new series). 2008;13(1):23–9.
24. Lai KN, Li PK, Lui SF, Au TC, Tam JS, Tong KL, et al. Membranous nephropathy related to hepatitis B virus in adults. N Engl J Med. 1991 May 23;324(21):1457–63. http://dx.doi.org/10.1056/NEJM199105233242103
25. Li P, Wei RB, Tang L, Wu J, Zhang XG, Chen XM. Clinical and pathological analysis of hepatitis B virus-related membranous nephropathy and idiopathic membranous nephropathy. Clin Nephrol. 2012 Dec;78(6):456–64. http://dx.doi.org/10.5414/CN107615
26. Lee HS, Choi Y, Yu SH, Koh HI, Kim MJ, Ko KW. A renal biopsy study of hepatitis B virus-associated nephropathy in Korea. Kidney Int. 1988 Oct;34(4):537–543. http://dx.doi.org/10.1038/ki.1988.215
27. Collins AB, Bhan AK, Dienstag JL, Colvin RB, Haupert GT Jr, Mushahwar IK, et al. Hepatitis B immune complex glomerulonephritis: Simultaneous glomerular deposition of hepatitis B surface and e-antigens. Clin Immunol Immunopathol. 1983 Jan;26(1):137–53. http://dx.doi.org/10.1016/0090-1229(83)90182-4
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29. Lai KN, Ho RT, Tam JS, Lai FM. Detection of hepatitis B virus DNA and RNA in kidneys of HBV-related glomerulonephritis. Kidney Int. 1996 Dec;50(6):1965–77. http://dx.doi.org/10.1038/ki.1996.519
30. Xie Q, Yan Li Y, Xue J, Xiong Z, Wang L, Sun Z, et al. Renal phospholipase A2 receptor in hepatitis B virus-associated membranous nephropathy. Am J Nephrol. 2015;41(4–5):345–53. http://dx.doi.org/10.1159/000431331
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Nov 9, 2020
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HBV Hepatitis and Related Renal Nephropathies: Pathogenesis and Treatment. (2020). Journal of Renal and Hepatic Disorders, 4(2), 67-74. https://doi.org/10.15586/jrenhep.2020.85
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Review Nephrology
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