Relationship Between Serum DNA Replication, Clinicopathological Characteristics and Prognosis of Hepatitis B Virus-associated Glomerulonephritis with Severe Proteinuria by Lamivudine Plus Adefovir Dipivoxil Combination Therapy

• Published in: Biomedical and environmental sciences 2015-03, Vol.28 (3), p.206-213
• Main Authors: JIANG, Wei, LIU, Tuo, DONG, Hui, XU, Yan, LIU, Li Qiu, GUAN, Guang Ju, LIU, Xiang Chun
• Format: Article
• Language: English
• Subjects: Adefovir dipivoxil; Adenine - analogs & derivatives; Adenine - therapeutic use; Adult; Aged; Antiviral Agents - therapeutic use; DNA Replication; DNA, Viral - blood; DNA复制; Drug Therapy, Combination; Female; Glomerulonephritis - etiology; Hepatitis B - complications; Hepatitis B - drug therapy; Hepatitis B virus; Hepatitis B virus - genetics; Humans; Lamivudine; Lamivudine - therapeutic use; Male; Middle Aged; Nephritis; Organophosphonates - therapeutic use; Pathology; Prognosis; Proteinuria; Proteinuria - etiology; Young Adult; 临床病理; 乙型肝炎病毒; 拉米夫定; 联合治疗; 血清; 阿德福韦酯; 预后
• ISSN: 0895-3988; 2214-0190
• DOI: 10.3967/bes2015.027

Objective To explore the relationship between HBV DNA and the clinical manifestations, pathological types, injury severity, and prognosis with HBV-GN. Methods 102 patients with HBV-GN were divided into 3 groups, according to the serum titer of the HBV DNA. 24-h urine protein excretion, and other parameters were measured. Renal biopsy were performed. The association between HBV DNA and the pathological stage of membranous nephropathy was analyzed in 78 patients with HBV-MN. 24-h urine protein excretion was used for the evaluation of the prognosis, and the relationship between HBV DNA and prognosis were analyzed. Results Several findings were demonstrated with the increase of serum HBV DNA： 24-h urine protein excretion, plasma cholesterol, and triglycerides increased significantly（P〈0.05）, while the plasma level of albumin decreased significantly（P〈0.05）; The changes of serum creatinine, C3 and C4 were found but no statistical significance. Glomerular deposition of HBVAg increased, and the pathological injury was more severe. The clinical remission rate was lower in the high replication group after treatment as compared with the low replication group（P〈0.01）. Conclusion With the increase of serum HBV DNA, the urine protein excretion and the kidney injury were more severe, and the clinical remission rate was decreased.