Clinical Study of Mycophenolate Mofetil Combined with Interferon-α Treating Children with Refractory HBV-associated Nephritis

Objective To observe the curative effects of mycophenolate mofetil(MMF)combined with interferon-α(IFN-α)treating HBV-associated nephritis and the influence of MMF on replication of HBV.Methods Six children with proteinuria(protein output 50 mg·kg～-1·24 h～-1),HBsAg(+),HBeAg(+),anti-HBc(+),slight liver dysfunction and prednisone(2 mg·kg～-1·d～-1 for 8 weeks)treatment failure in other hospitals were finally diagnosed as HBV-associated nephritis by renal biopsy,then they were treated with MMF 800～1000 mg·m～-2·d～-1 for six months and then 500 mg·m～-2·d～-1 for three months combined with interferon-α 1MU,three times a week for six months.Results Proteinuria of all patients became negative after one to three months and the heightened serum aminotransferase level decreased to normal level.Six months later,serum HBsAg,HBeAg and anti-HBc became negative and HBV-DNA couldn't be detected in four of these children.However,serum HBsAg,HBeAg and anti-HBc were still positive in another two children and HBV-DNA had no distinguished change.Proteinuria kept negative in five children for 10～42 months.Conclusion Mycophenolate mofetil combined with interferon-α may be an efficient therapy for HBV-associated nephritis,especially when the patients are refractory to the traditional therapy,and HBV-DNA is actively copied and aminotransterase rise.