Glomerulonephritis Associated With Hepatitis B Virus Infection in Children

Hepatitis B surface antigen (HBsAg) was identified by a reversed passive hemagglutination (RPHA) method in the serum of 13 of 15 patients with membranous glomerulonephritis (MGN), three of three Type III membranoproliferative GN (MPGN) proposed by Burkholder, three of 25 idiopathic minimal change nephrotic syndrome (IMCNS), three of 37 minor glomerular alterations with undetermined diagnosis (MGA) and none of 79 various other renal disease, in 266 Japanese children. Immunofluorescent studies showed granular deposition of Hepatitis B e antigen (HBeAg) in a similar pattern to that of IgG and β1C in the kidney of four patients with MGN, and of HBsAg in one with Type III MPGN. Eight of 13 MGN with positive serum HBsAg, two of three Type III MPGN and one of one MGA with positive serum HBs Ag had normalization of urinary findings during the observation period of one to eight years. Eight (5 MGN, 2 Type III MPGN and 1 MGA) of those with positive serum HBeAg showed seroconversion of HBeAg, and anti-HBe appeared in five of eight as the urinary findings became normal. The normalization of urinary findings accompanied by seroconversion of HBeAg in the patients with MGA and with Type III MPGN suggests that HBeAg is the most important antigen involved in HB virus (HBV) associated GN including not only MGN but also Type III MPGN and MGA.