Clinicopathological Analysis for Nephritis Accompanied by Hepatitis B Virus (HBV) Antigens Depositing in Glomeruli in 68 Cases

Objective:To investigate clinicopathological features of HBV related glomerulonephritis(HBV-GN), the deposition of HBV related antigens in glomeruli were examined,and the association between serum markers of HBV and antigen deposition as well as the pathological manifestations were investigated.Methods:68 cases patients with deposition of HBV related antigens in glomeruli were involved in this study (group A). 24 cases without depositing were divided into group B. Detecting HBsAg and HBcAg in renal tissues by indirect immunofluorescence, and serum HBV-DNA by polymerase chain reaction.Results:The blood pressure,hematuria, albuminuria, renal function are indifferent between the two groups (P0.05).In group A,the major renal pathological categories are IgA nephritis (IgAN,51.5%) and atypical membranous changes(MN,38.2%), the next are membranoproliferative changes (MPGN) and mesangial proliferative changes (MsPGN). In group B,the major are MsPGN (50%).Serum markers of HBV are all negative in 6, and only HbsAb positive in 7 In group A. The renal pathological categories of these 13 cases are MN in 9, IgAN in 3 and MPGN in 1.13 cases with markers negative or only HbsAb positive can be found antigens depisition in glomeruli, whose copy of virus are all below 103 per millilitre and the depositions of immunoglobulins and complements are multiple,full-lighesin 7cases(53.8%), light microscope showed atipical MN in 9(69.2%),IgAN in 3,MPGN in 1.Conclusion:It is difficult for adults to diagnose HBV-GN according to clinical features. The pathological manifestations of adults HBV-GN are diversified, the major are IgAN and atypical MN, the next are MPGN and MsPGN, FSGS is rare. People with HBV markers negative or only HbsAb positive can also be found HBV antigens depisition in glomeruli, which signified the importance of renal tissue examination of HBV antigens,espically those patients with negative blood HBV markers.