Hepatitis B virus replication in acute glomerulonephritis with chronic active hepatitis

Area of Science:

• Nephrology
• Hepatology
• Virology

Background:

• Chronic active hepatitis B (CAHB) is a persistent liver infection.
• Hepatitis B virus (HBV) replication can lead to extrahepatic manifestations.
• Membranous glomerulonephritis (MGN) is a kidney disease often associated with infections.

Observation:

• A 3-year-old boy with CAHB developed acute MGN.
• The patient had detectable hepatitis B e antigen and antibody during MGN onset.
• HBV replication was active at the time of kidney disease development.

Findings:

• Withdrawal of short-term steroid treatment led to MGN remission.
• Resolution of HBV replication coincided with the remission of both MGN and CAHB.
• Hepatitis B surface antigen (HBsAg) became undetectable months later.

Implications:

• HBV infection is a potential cause of glomerulonephritis in children.
• Management of HBV replication may be crucial for treating HBV-associated kidney disease.
• Remission of HBV infection can lead to the resolution of associated nephropathies.