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

The frequency of hepatitis B Surface antigen (HBsAg) was studiedin the sera of 311 patients with various forms of primary glomerulonephritisand 43 patients with lupus nephritis. HBs antigenaemia was detectedin 69 of the 311 patients (22 per cent) with primary glomerulonephritisand this prevalence of HBaAg carrier was significantly higherthan that in the general population (p<0. 001). These patientshad no clinical or biochemical findings to suggest acute orchronical liver disease. A higher HBs antigenaemia carrier ratewas not observed in patients with lupus nephritis. Three glomerulopathologicalentities, membranous nephropathy. IgA nephropathy, and mesangialproliferative glomerulonephrities, were found to be associatedwith a higher prevalence of HBs antigenaemia compared with thegeneral population (p<0. 001). Glomerular deposits of HBsAgand/or hepatitics core antigen (HBcAg) were detected in 41,61, and 60 per cent of renal biopsy specimens from patientswith membranous nephropathy, Iga nephropathy, and mesangialproliferative glomerulonephritis associated with persistentHBs antigenaemia respectively. During the mean study periodof 40 months (range 12–180), 14 per cent of these patientswith hepatitis-associated glomerulonephrities developed progressiverenal failure, althrough none required maintenanece dialysis.Our study suggests that hepatitis B virus antigenaemia may playa significant role in the developement of specific forms ofglomerulonephritis and that these hepatities B virus-associatedglomerulonephritides can run an indolent but relentless progressiveclinical course.