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      Hepatitis B Virus-Associated Membraneous Nephropathy: Clinical Features, Immunological Profiles and Outcome


      S. Karger AG

      Hepatitis B virus, Membraneous nephropathy, HBe antigen

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          To evaluate the clinical features, immunological profiles and the prognosis of hepatitis B virus-associated membraneous nephropathy (HBVMN), 34 patients (25 boys and 9 girls) were studied from April 1981 to November 1987. With Fab fragments of monoclonal antibodies, hepatitis B e antigen (HBeAg) was detected in the glomerular deposits from 30 cases (88.2%) and in the sera from 32 cases (94.1%). These results suggest that HBeAg plays an important role in the development of HBVMN. In addition, clinical trials of 32 cases demonstrate a relatively poor response to the steroid therapy with persistent heavy proteinuria (32.4%) or a high frequent relapse rate (38.2%); only 1 case (3.1%) had early response. In 4 cases follow-up renal biopsy was performed, progressive sclerosis with interstitial fibrosis being noted in each instance. The stage of membraneous nephropathy examined under the light microscope, had progressed from stage I or II to stage III. One had impaired renal function. Therefore, HBVMN does not always take a benign course. In the immunological profiles, significant hypocomplementemia with low C3, C4 and properdin factor B levels were found during the initial 6 months after the onset of disease. Hepatitis B surface antigen (HBsAg) circulating immune complexes (CIC) were also significantly higher. However, the levels of HBsAg CIC did not correlate with the degree of proteinuria or hematuria. In patients with persistent HBsAg carriage, serum HBeAg status alone did not correlate with remission rate, and remission occurred usually before the HBeAg seroconversion to anti-HBe. These results suggest that factors other than HBeAg play important roles in HBVMN.

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          Author and article information

          S. Karger AG
          10 December 2008
          : 55
          : 1
          : 37-44
          Departments of Medical Research and Pediatrics, Veterans General Hospital, Taipei, Taiwan
          185916 Nephron 1990;55:37–44
          © 1990 S. Karger AG, Basel

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          Page count
          Pages: 8
          Original Paper

          Cardiovascular Medicine, Nephrology

          HBe antigen, Membraneous nephropathy, Hepatitis B virus


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