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. 1983 Jul;58(7):488–496. doi: 10.1136/adc.58.7.488

Hepatitis B virus associated membranous glomerulonephritis.

J Wiggelinkhuizen, C Sinclair-Smith, L M Stannard, H Smuts
PMCID: PMC1628176  PMID: 6870328

Abstract

The incidence of persistent hepatitis B surface (HBs) antigenaemia was studied in 114 nephrotic children with glomerulonephritis. Twenty five (24 boys) of 28 cases of membranous glomerulonephritis were HBs antigen (HBsAg) carriers. Only 9 of the remaining 86 patients with nephropathies other than membranous glomerulonephritis were HBsAg positive. HBsAg immune complexes were seen in the sera by electron microscopy. On radioimmunoassay both HBsAg and antibody (anti-HBs), and HBeAg and antibody (anti-HBe) were often detected concurrently, HBsAg was not shown in the glomerular capillary wall. HBs antigenaemia persisted in 80% of patients after recovery from glomerulonephritis but remission of the proteinuria correlated well, although not fully, with seroconversion to anti-HBe. The natural history of hepatitis B virus (HBV) associated glomerulonephritis in childhood is one of slow recovery. A few patients are left with mild asymptomatic proteinuria but progressive renal failure is rare. The 14% incidence of membranous glomerulonephritis in nephrotic children in this area is much higher than that found by the international study of kidney disease in children in well developed countries and is probably related to a high HBV carrier rate. A search for HBV markers should be included in the investigation of persistent glomerulonephritis, particularly in countries with a high prevalence of HBV carriers.

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Selected References

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  1. Bajtai G., Ambrus M., Paál M., Nagy J., Deák G. Letter: Hepatitis-B antigenaemia associated with progressive cirrhosis and membranous glomerulonephritis. Lancet. 1975 Jan 11;1(7898):102–103. doi: 10.1016/s0140-6736(75)91108-3. [DOI] [PubMed] [Google Scholar]
  2. Brzosko W. J., Krawczyński K., Nazarewicz T., Morzycka M., Nowoslawski A. Glomerulonephritis associated with hepatitis-B surface antigen immune complexes in children. Lancet. 1974 Aug 31;2(7879):477–482. doi: 10.1016/s0140-6736(74)92012-1. [DOI] [PubMed] [Google Scholar]
  3. Combes B., Shorey J., Barrera A., Stastny P., Eigenbrodt E. H., Hull A. R., Carter N. W. Glomerulonephritis with deposition of Australia antigen-antibody complexes in glomerular basement membrane. Lancet. 1971 Jul 31;2(7718):234–237. doi: 10.1016/s0140-6736(71)92572-4. [DOI] [PubMed] [Google Scholar]
  4. Dixon F. J. The pathogenesis of glomerulonephritis. Am J Med. 1968 Apr;44(4):493–498. doi: 10.1016/0002-9343(68)90050-8. [DOI] [PubMed] [Google Scholar]
  5. Gocke D. J. Extrahepatic manifestations of viral hepatitis. Am J Med Sci. 1975 Jul-Aug;270(1):49–52. doi: 10.1097/00000441-197507000-00007. [DOI] [PubMed] [Google Scholar]
  6. Hirsch H. Z., Ainsworth S. K., DeBeukelaer M., Brissie R. M., Hennigar G. R. Membranous glomerulonephritis in a child asymptomatic for hepatitis B virus. Concomitant seropositivity for HBsAG and anti-HBs. Am J Clin Pathol. 1981 Apr;75(4):597–602. doi: 10.1093/ajcp/75.4.597. [DOI] [PubMed] [Google Scholar]
  7. Hirschel B. J., Benusiglio L. N., Favre H., Chatelanat F., Humair L., Zubler R. H., Cruchaud A. Glomerulonephritis associated with hepatitis B. report of a case and review of the literature. Clin Nephrol. 1977 Sep;8(3):404–409. [PubMed] [Google Scholar]
  8. Ito H., Hattori S., Matusda I., Amamiya S., Hajikano H., Yoshizawa H., Miyakawa Y., Mayumi M. Hepatitis B e antigen-mediated membranous glomerulonephritis. Correlation of ultrastructural changes with HBeAg in the serum and glomeruli. Lab Invest. 1981 Mar;44(3):214–220. [PubMed] [Google Scholar]
  9. Kleinknecht C., Levy M., Peix A., Broyer M., Courtecuisse V. Membranous glomerulonephritis and hepatitis B surface antigen in children. J Pediatr. 1979 Dec;95(6):946–952. doi: 10.1016/s0022-3476(79)80281-4. [DOI] [PubMed] [Google Scholar]
  10. Knecht G. L., Chisari F. V. Reversibility of hepatitis B virus-induced glomerulonephritis and chronic active hepatitis after spontaneous clearance of serum hepatitis B surface antigen. Gastroenterology. 1978 Dec;75(6):1152–1156. [PubMed] [Google Scholar]
  11. Kohler P. F., Cronin R. E., Hammond W. S., Olin D., Carr R. I. Chronic membranous glomerulonephritis caused by hepatitis B antigen-antibody immune complexes. Ann Intern Med. 1974 Oct;81(4):448–451. doi: 10.7326/0003-4819-81-4-448. [DOI] [PubMed] [Google Scholar]
  12. Madaliński K., Bragiel I. HBsAg immune complexes in the course of infection with hepatitis B virus. Clin Exp Immunol. 1979 Jun;36(3):371–378. [PMC free article] [PubMed] [Google Scholar]
  13. Maggiore Q., Bartolomeo F., L'Abbate A., Misefari V. HBsAg glomerular deposits in glomerulonephritis: fact or artifact? Kidney Int. 1981 Apr;19(4):579–586. doi: 10.1038/ki.1981.55. [DOI] [PubMed] [Google Scholar]
  14. McCollum R. W., Zuckerman A. J. Viral hepatitis: report on WHO informal consultation. J Med Virol. 1981;8(1):1–29. doi: 10.1002/jmv.1890080102. [DOI] [PubMed] [Google Scholar]
  15. Myers B. D., Griffel B., Naveh D., Jankielowiiz T., Klajman A. Membrano-proliferative glomerulonephritis associated with persistent viral hepatitis. Am J Clin Pathol. 1973 Aug;60(2):222–228. doi: 10.1093/ajcp/60.2.222. [DOI] [PubMed] [Google Scholar]
  16. Nagy J., Bajtai G., Brasch H., Süle T., Ambrus M., Deák G., Hámori A. The role of hepatitis B surface antigen in the pathogenesis of glomerulopathies. Clin Nephrol. 1979 Sep;12(3):109–116. [PubMed] [Google Scholar]
  17. Nowoslawski A., Krawczynski K., Nazarewicz T., Slusarczyk J. Immunopathological aspects of hepatitis type B. Am J Med Sci. 1975 Sep-Oct;270(2):229–239. doi: 10.1097/00000441-197509000-00002. [DOI] [PubMed] [Google Scholar]
  18. Slusarczyk J., Michalak T., Nazarewicz-de Mezer T., Krawczyński K., Nowosławski A. Membranous glomerulopathy associated with hepatitis B core antigen immune complexes in children. Am J Pathol. 1980 Jan;98(1):29–43. [PMC free article] [PubMed] [Google Scholar]
  19. Stannard L. M., Lennon M., Hodgkiss M., Smuts H. An electron microscopic demonstration of immune complexes of hepatitis B e-antigen using colloid gold as a marker. J Med Virol. 1982;9(3):165–175. doi: 10.1002/jmv.1890090303. [DOI] [PubMed] [Google Scholar]
  20. Stannard L. M., Moodie J., Keen G. A., Kipps A. Electron microscopic study of the distribution of the Australia antigen in individual sera of 50 serologically positive blood donors and two patients with serum hepatitis. J Clin Pathol. 1973 Mar;26(3):209–216. doi: 10.1136/jcp.26.3.209. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Stevens C. E., Beasley R. P., Tsui J., Lee W. C. Vertical transmission of hepatitis B antigen in Taiwan. N Engl J Med. 1975 Apr 10;292(15):771–774. doi: 10.1056/NEJM197504102921503. [DOI] [PubMed] [Google Scholar]
  22. Stratta P., Camussi G., Ragni R., Vercellone A. Letter: Hepatitis-B antigenaemia associated with active chronic hepatitis and mesangioproliferative glomerulonephritis. Lancet. 1975 Jul 26;2(7926):179–179. doi: 10.1016/s0140-6736(75)90082-3. [DOI] [PubMed] [Google Scholar]
  23. Takekoshi Y., Tanaka M., Miyakawa Y., Yoshizawa H., Takahashi K., Mayumi M. Free "small" and IgG-associated "large" hepatitis B e antigen in the serum and glomerular capillary walls of two patients with membranous glomerulonephritis. N Engl J Med. 1979 Apr 12;300(15):814–819. doi: 10.1056/NEJM197904123001502. [DOI] [PubMed] [Google Scholar]
  24. Takekoshi Y., Tanaka M., Shida N., Satake Y., Saheki Y., Matsumoto S. Strong association between membranous nephropathy and hepatitis-B surface antigenaemia in Japanese children. Lancet. 1978 Nov 18;2(8099):1065–1068. doi: 10.1016/s0140-6736(78)91801-9. [DOI] [PubMed] [Google Scholar]
  25. Tedder R. S., Bull F. G. Characterization of 'e' antigen associated with hepatitis B. Clin Exp Immunol. 1979 Mar;35(3):380–389. [PMC free article] [PubMed] [Google Scholar]
  26. Vos G. H., Grobbelaar B. G., Milner L. V. A possible relationship between persistent hepatitis B antigenaemia and renal disease in Southern African Bantu. S Afr Med J. 1973 Jun 2;47(21):911–912. [PubMed] [Google Scholar]

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