Effect of hepatitis B virus infection on membranous nephropathy

Purpose To investigate the renal pathological features of biopsy-proved membranous nephropathy (MN) with hepatitis B virus(HBV) infection and the significance of HBV related antigens detection in kidney.Methods Retrospective analysis of clinicopathological features was conducted in 147 cases of MN,which were divided into group A (HBV antigens positive),group B (only HBV antibodies positive) and group C (idiopathic MN with no HBV infection) according to serum markers of HBV.The renal pathological changes,clinical manifestations and laboratory results were compared.The depositions of HBsAg and HBcAg were detected by immunohistochemistry of EnVision method.Results The occurrence rate of duplication of glomerular basement membrane (GBM),segmental endothelial cells proliferation,segmental glomerular sclerosis,dense deposition in subendothelial and mesangial region and depositions of IgM,C4 and C1q in glomeruli in group A was significantly higher than that in group C (P0.05).The age onset in the group A was much younger,the ratio of hepatic insufficiency and hypocomplementemia was obviously higher than that in groups B and C (P0.05).No significant differences were found in clinicopathological features between two groups with and without HBsAg and/or HBcAg deposition in kidney in group A.Conclusions Unlike idiopathic MN,MN with HBV infection commonly presents focal segmental sclerosis,endothelial cells proliferation,duplication of GBM and multiple immunoglobulins or complements deposition in glomeruli.Whether MN related to HBV infection or not can not only rely on the immunohistochemical detection of HBV antigens in renal tissue,but also on the histological changes under light,immunofluorescence and eletron microscopy.