Efficacy and safety of anti-viral therapy for Hepatitis B virus-associated glomerulonephritis: A meta-analysis

Abstract

Objectives To assess the potency of anti-viral treatment for hepatitis B virus-associated glomerulonephritis (HBV-GN). Method: We searched for controlled clinical trials on anti-viral therapy for HBV-GN in MEDLINE, Embase, the Cochrane Library, and PubMed from inception to March 11 th 2019. Seven trials, including 182 patients met the criteria for evaluating. The primary outcome measures were proteinuria and changes in the estimated glomerular filtration rate, and the secondary outcome measure was hepatitis B e-antigen clearance. A fixed or random effect model was established to analyze the data. Subgroup analyses were performed to explore the effects of clinical trial type, anti-viral drug type, age, and follow-up duration. Results The total remission rate of proteinuria (OR = 10.48, 95% CI: 4.60−23.89, I 2 = 0%), complete remission rate of proteinuria (OR = 11.64, 95% CI: 5.17−26.21, I 2 = 23%) and clearance rate of Hepatitis Be Antigen (HBeAg) were significantly higher in the anti-viral treatment group than in the control group (OR = 27.08, 95% CI: 3.71−197.88, I 2 = 63%). However, antiviral therapy was not as effective regarding the eGFR (MD = 5.74, 95% CI:-4.24−15.73). In the subgroup analysis, age and drug type had significant impacts on proteinuria remission, and study type and follow-up duration only slightly affected the heterogeneity. Conclusion Antiviral therapy induced remission of proteinuria and increased HBeAg clearance but failed to improve the eGFR. Pediatric patients were more sensitive to antiviral therapy than adults. IFNs seem more effective but are accompanied by more adverse reactions than NAs.

Bone marrow mesenchymal stem cell-derived exosomes protect podocytes from HBx-induced ferroptosis

“…At present, antivirus therapy has been the backbone of HBV-GN treatment due to its efficacy in HBV clearance and proteinuria remission, but fails to improve the glomerular filtration rate ( Fu et al, 2020 ). Therefore, there is an urgent need for more effective treatments to reduce the occurrence and progression of HBV-GN.…”

Application of Real-Time Shear Wave Elastography in The Evaluation of Acute Hepatitis After Treatment

“…The pathogenesis of acute viral hepatitis is mainly direct liver cell damage with a total course of 2 to 4 months and has a slow recovery. Autoimmune hepatitis is an acute attack of chronic hepatitis, which gradually recovers after symptomatic treatment [21][22].…”

Nephrotic syndrome: ethiological factors and differential diagnosis

“…Поражение почек может наблюдаться также в рамках HBV-ассоциированного криоглобулинемического васкулита или узелкового полиартериита, хотя последний сегодня встречается очень редко и не приводит к развитию НС. Пациентам с HBV-ассоциированным гломерулонефритом показана терапия аналогами нуклеот(з)идов, которая в клинических исследованиях увеличивала вероятность снижения протеинурии и достижения ремиссии заболевания [57].…”