Pathological changes of liver and kidney in adult patients with hepatitis B virus-associated glomerulonephritis

Objective To investigate the pathological changes of liver and kidney in adult patients with hepatitis B virus-associated glomerulonephritis(HBV-GN) and to observe the distribution of hepatitis B virus antigen in the livers and kidneys. Methods Forty-four HBV-GN patients were confirmed by renal biopsy, and ten of them also underwent liver biopsy. The morphological changes of biopsy specimens were observed by light microscopy and immunofluorescent staining; immunohistochemical techniques were used to observe HBV markers(HBsAg, HBcAg) in the renal and liver specimens; and HBVDNA was detected by molecular hybridization in situ. Results Histological findings indicated that IgA nephropathy (IgAN) was the dominant type in our group (27.3%), followed by membranous nephropathy (MN) (22.7%). HBsAg and/or HBcAg were presented in IgAN and mesangial proliferative glomerulonephritis (MsPGN). HBsAg was only expressed in MN, minimal change disease (MCD) and membranoproliferative glomerulonephritis (MPGN). HBV-DNA was mainly detected in the cytoplasm of proximal tubular epithelia but not in glomerular cells. Patients had different degrees of hepatic lesions, with mild lesions accounting for 80%; HBsAg was commonly observed in mild lesions. Presence of both HBcAg and HBsAg in the liver indicated the existence moderate and severe lesions.Conclusions HBV-GN patients have different types of renal lesions, with IgA and MN being the dominant types. The lesions of liver are mainly mild hepatitis.