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Characteristics of glomerular lesions in hepatitis B virus infection
1First Department of Internal Medicine, School of Medicine, Kanazawa University, Japan.
Abstract:
In an attempt to clarify a participation of hepatitis B virus (HBV) in the development of hepatic glomerulopathy in adults, kidney specimens obtained from 151 patients with liver diseases were studied. Although mesangial proliferation was more severe in patients with chronic hepatitis or liver cirrhosis than in those with acute hepatitis, no significant difference was observed between 82 serum hepatitis B surface antigen (HBsAg)-positive (HBV-related group) and 69 negative patients (HBV-nonrelated group). However, double contours of the glomerular capillary walls were observed more often in the former group (18/82, P less than .01), especially in the HBeAg-positive subgroup (8/24, P less than .001), than in the latter (3/69). In addition, glomerular capillary spike formation or a bubblelike appearance was observed in seven patients of the former group. Of these, all five patients examined were HBeAg-positive in their serum. By electron microscopic studies, subendothelial dense deposits and mesangial interpositions were observed more frequently in the HBV-related group, and subepithelial deposits were found only in the HBeAg-positive subgroup. The immunofluorescence study revealed IgA-dominant mesangial deposition in both HBV-related and nonrelated groups. As for the capillary wall deposits, however, IgG was dominant in 13 of the HBV-related group, but only one of the nonrelated group (P less than .01). Furthermore, one patient in the HBV-related group showed capillary wall-dominant HBeAg combined with IgG deposition.(ABSTRACT TRUNCATED AT 250 WORDS)
Insights
Hepatitis B virus (HBV) infection is linked to specific kidney changes in adults. HBV-related glomerulopathy shows distinct glomerular capillary wall alterations, particularly in HBeAg-positive patients.
Area of Science:
- Nephrology
- Hepatology
- Virology
Background:
- Hepatitis B virus (HBV) infection is a global health concern.
- The role of HBV in the development of glomerulopathy in adults requires further clarification.
Purpose of the Study:
- To investigate the association between HBV infection and the development of hepatic glomerulopathy in adult patients.
- To identify specific kidney pathological changes related to HBV in liver disease patients.
Main Methods:
- Kidney biopsy specimens from 151 adult patients with liver diseases were analyzed.
- Patients were categorized into HBV-related (HBsAg-positive) and HBV-nonrelated groups.
- Histopathological, immunofluorescence, and electron microscopic studies were performed.
Main Results:
- Double contours of glomerular capillary walls were significantly more frequent in the HBV-related group (18/82) than the HBV-nonrelated group (3/69).
- Glomerular capillary spike formation and subendothelial dense deposits were more common in HBV-related cases.
- Subepithelial deposits were exclusively found in HBeAg-positive HBV patients, and IgG deposition in capillary walls was more prevalent in the HBV-related group.
Conclusions:
- HBV infection is associated with specific glomerular alterations, including double contours and spike formation.
- The presence of HBeAg and IgG deposition in capillary walls may indicate a more severe form of HBV-related glomerulopathy.
- These findings highlight the importance of considering HBV in the differential diagnosis of glomerulonephritis in patients with liver disease.