HBV-Associated Postinfectious Acute Glomerulonephritis: A Report of 10 Cases

Abstract

Postinfectious acute glomerulonephritis (PIGN) may occur after various bacterial and viral infections. Hepatitis B virus (HBV) infection is a cause of chronic glomerulonephritis. We report here 10 cases (ages 7–20 years-old) of chronic HBV carriers with acute glomerulonephritis, with positive glomerular staining of hepatitis B surface antigen, and detectable presence of HBV DNA in the glomeruli. This form of PIGN, HBV-PIGN, has not been previously identified. To further characterize clinical and pathological features of HBV- PIGN, we selected 10 cases of age-matched non-HBV PIGN for comparison. While both HBV associated PIGN and non-HBV PIGN similarly presented as proteinuria, hematuria, and hypertension, there was a trend of higher acute kidney injury and worsened prognosis in HBV-PIGN. 6 months after the onset, 4 patients with HBV associated PIGN did not show improvement from the disease, whereas all patients with non-HBV PIGN had complete or partial recovery. Pathologically, both HBV associated PIGN and non-HBV PIGN showed typical diffuse glomerular endocapillary proliferation, but HBV associated PIGN differed from classical PIGN with much fewer sub-epithelial glomerular “hump-shape” immune complex depositions. In conclusion, we have identified a novel association of HBV infection with acute glomerulonephritis.

Viral Hepatitis A and B as Differential in Children Presenting with Acute Glomerulonephritis

“…While a significant reduction in prevalence of HBsAg carriers and HBV associated membranous nephropathy in children after extensive HBV immunization in recent years has been reported, HBV-GN remains a significant problem 6 . Pathologically, HBV-PIGN exhibited the typical changes associated with acute glomerulonephritis, including glomerular endocapillary proliferation and deposition of immunoglobulins, and deposition of complements C3 and C4 8 . The abovedescribed cases indicate that history, clinical examination and simple laboratory investigation and can lead us to diagnosis of glomerulonephritis and associated hepatitis.…”

Echinacoside promotes the proliferation of human renal tubular epithelial cells by blocking the HBX/TREM2‑mediated NF‑κB signalling pathway

“…HBV, not only causes persistent or transient infection in the liver, but also infects extrahepatic tissue, including the pancreas, bile duct, lymphoid system and kidneys (2). Moreover, HBV infection is closely associated with chronic glomerulonephritis (HBV-Gn); however, the molecular mechanisms of HBV during HBV-Gn are not completely understood (3,4).…”