Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019163 (hepatitis B)
 38,309 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The frequency of hepatitis B surface antigen (HBsAg) was studied in the sera of 622 patients with glomerulonephritis (GN). The prevalence of HBs-antigenemia was 2.8% (18/622; eleven adults and seven children); the difference from 2.6% in the general population of Central and Southern Greece was not statistically significant (chi 2 = 0.01; p > 0.50). Two of the 11 HBsAg-seropositive adult patients with GN suffered from IgA nephropathy, one from IgA and membranous glomerulonephritis (MGN), four from diffuse proliferative GN, two from membranous GN and one each from crescentic GN and focal segmental glomerulosclerosis. Five children out of 12 with membranous glomerulonephritis, one out of 24 with IgA nephropathy and one out of 16 with focal segmental glomerulosclerosis had HBs-antigenemia. The frequency of HBs-antigenemia in children with MGN was 41.7%, which is significantly higher than in children with other types of GN (0.9%). All seropositive patients were asymptomatic HBsAg carriers, while one seropositive HBsAg child with MGN suffered from chronic persistent hepatitis. HBsAg was detected by the immunoperoxidase-antiperoxidase (PAP) method in the glomeruli of only 3 children with MGN and HBs antigenemia, while HBcAg was not detected in any case. Our study suggests that in the Greek population there is no increased prevalence of HBs-antigenemia in patients with glomerulonephritis. Moreover, HBsAg was not found to contribute in the pathogenesis of GN in adults but it may be associated with the pathogenesis of membranous GN in children.
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PMID:The frequency of hepatitis B virus infection in Greek patients with various types of glomerulonephritis. 767 56

Among 178 African children with nephrotic syndrome, membranous nephropathy was the commonest histological lesion (60 children; 34%). Fifty-seven (95%) of these 60 were hepatitis B surface antigen (HBsAg)-positive, and 52 (86%) of these 57 were hepatitis B 'e' antigen (HBeAg)-positive. HBsAg was detected in only six (5%) and HBeAg in one (0.8%) of the 118 patients with non-membranous lesions. The risk of membranous nephropathy was 35 and 15 times higher in the 178 African children with nephrotic syndrome who had serological evidence of HBsAg and HBeAg, respectively, than in those who did not. Sensitivity was 95% for HBsAg and 87% for HBeAg; specificity, and positive and negative predictive values were above 90% for each antigen. The strength of such an association in this particular community permits reliable prediction of membranous nephropathy from serological tests for HBsAg and HBeAg, thereby avoiding renal biopsy.
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PMID:Hepatitis B 's' and 'e' antigen carriage in childhood nephrotic syndrome predicts membranous glomerulonephritis. 768 50

An open, randomized trial study on the therapeutic effect of recombinant alpha-interferon (IFN alpha) in 40 patients with hepatitis B virus membranous nephropathy (HBVMN) was conducted. All were pathologically proven to have HBVMN which showed no response to corticosteroid treatment represented by persistent heavy proteinuria. Both HBeAg and HBsAg were positive in all. Group 1 was composed of 20 patients who were treated with recombinant IFN alpha (5 subjects, body wt < 20 kg; 8 subjects, body weight > or = 20 kg) by subcutaneous (s.c.) injection three times a week for 12 months. In group 2 there were 20 patients who received supportive treatment only. At the end of the third month of treatment, all patients in Group 1 were free of proteinuria. In contrast, 10 patients (50%) in Group 2 had persistent heavy proteinuria and another 10 patients (50%) had light proteinuria with exacerbation during respiratory tract infection. At the end of the twelfth month, 8 patients (40%) in Group 2 still had persistent heavy proteinuria and 12 patients (60%) had light proteinuria with frequent relapses. Eight patients (40%) in Group 1 had HBeAg seroconversion between the fourth and sixth months and HBsAg seroconversion between the tenth and twelfth months. HBe seroconversion only [HBeAg (-)/HBsAg (+)] was found in four patients. Four patients had no change in HBV serological markers [HBeAg (+)/HBsAg (+)]. The remaining 4 patients had HBeAg (-)/HBeAb (+) HBsAg (-)/HBsAb (-) at the end of the twelfth month. In contrast, there was no seroconversion of HBeAg (+)/HBsAg (+) in Group 2 patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Treatment of hepatitis B virus-associated membranous nephropathy with recombinant alpha-interferon. 773 Nov 50

Besides rejection-induced transplant glomerulopathy de novo membranous glomerulonephritis (MGN) is the most frequent cause of nephrotic syndrome after renal transplantation. We evaluated 1029 renal transplantations (271 without and 758 with cyclosporine treatment), performed on 848 patients between 1970 and 1992, which resulted in 872 functioning grafts. De novo MGN was seen in 30 biopsy specimens from 21 patients (about 2%), of whom 10 had received immunosuppressive treatment without and 11 with cyclosporine. Taking into account the longer periods of observation of patients without compared with those with cyclosporine treatment (88 +/- 60 vs. 41 +/- 31 mo., respectively, P = 0.001), the two treatment groups did not differ significantly in prevalence of de novo MGN (4.0% vs. 1.5%). De novo MGN was diagnosed by biopsy 62.7 +/- 44.4 mo. after transplantation; its incidence increased significantly with time (from 0% to 5.3% over 8 years; 95% confidential interval: 1.7-8%). Proteinuria (mean, 3.2 +/- 2.9 g/L) was first observed 47.5 +/- 51.3 mo. after transplantation. Thirteen of the 21 patients (62%) were nephrotic (proteinuria, over 1.5 g/L). Steroid pulses were given to 12 patients with de novo MGN and high proteinuria, which did not decline after treatment. Signs of chronic viral infection (hepatitis B antigen, hepatitis C antibody, or human immunodeficiency virus antibody) were found in 8 of the 21 patients (38%). Signs of vascular or interstitial rejection were seen in 17 and 12 of the 21 patients with de novo MGN, respectively, and cyclosporine arteriolopathy was diagnosed in four. Graft loss occurred in 14 of the 21 patients and was due to rejection in 13 and to de novo MGN in only one, who developed additional transplant vein thrombosis. Patients with de novo MGN did not differ significantly from the other 851 patients in graft survival (71.4 +/- 9.9% vs. 60.8 +/- 2.2% after 5 yr). De novo MGN is a late, often asymptomatic, complication of initially well tolerated grafts and is neither prevented by cyclosporine treatment nor reversed by further steroid medication. It is often associated with vascular changes caused by rejection or cyclosporine toxicity.
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PMID:Impact of de novo membranous glomerulonephritis on the clinical course after kidney transplantation. 794 Jun 83

Hepatitis B virus (HBV) infection is recognised as an important cause of nephrotic syndrome in endemic areas. This paper retrospectively examines the natural history and treatment of 70 patients with membranous glomerulonephritis and 1 with mesangiocapillary glomerulonephritis associated with HBV infection. Thirty-seven patients were in complete remission by the end of the study. The average duration of proteinuria in these patients was 30 months. The cumulative probability of remission was 64% at 4 years and 84% at 10 years. Three patients were still nephrotic after more than 90 months of follow-up and 2 others had reached end-stage renal failure. Remission occurred within 6 months of clearing the antigen (HBeAg) in the majority of cases. Steroids alone were given to 10 patients and 2 received steroids and cyclophosphamide, with no beneficial effect. Three patients received interferon-alpha 2b. One cleared the HBeAg from the circulation and had a significant fall in proteinuria, but defaulted from follow-up a month after completing treatment. One had a reduction of proteinuria but remained HBeAg positive. There was no change in the condition of the third. Although the majority of children eventually enter remission, there is a significant morbidity associated with the disease. Steroids and other immunosuppressive therapy are of no benefit. Interferon therapy may be useful, but has not been adequately assessed.
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PMID:The clinical course of hepatitis B virus-associated nephropathy. 814 8

The glomerular pathology and hepatitis B virus (HBV) antigens in renal biopsies were investigated in 100 consecutive patients with both primary glomerulonephritis and positive serology for hepatitis B surface antigen (HBsAg). Glomerular HBV antigens including HBsAg, hepatitis B core antigen (HBcAg), and hepatitis B e antigen (HBeAg) were examined in frozen tissue using both polyclonal and monoclonal antibodies. HBV serology and glomerular antigens were correlated. Using monoclonal antibodies, at least one of the three HBV antigens was detectable in glomeruli in 39% of the cases. These findings correspond mainly to detectable glomerular HBsAg and HBeAg in 22.3 and 28.4% of cases, respectively. A good correlation was found between glomerular and serum HBeAg but not observed for HBsAg. Serum HBcAg was not examined and not correlated with glomerular staining. When the diagnosis of HBV-related glomerulonephritis was based strictly on detectable glomerular antigens, three distinctive morphologies were identified: membranous nephropathy, mesangiocapillary glomerulonephritis, and mesangial proliferative glomerulonephritis with immunoglobulin A (IgA) deposits (IgA nephropathy). Each of these lesions may be seen in pure form or occasionally in overlapping form leading to double glomerulopathies. Glomerular HBeAg and HBsAg were associated with subepithelial and mesangial immune complexes, respectively. Rare overlap between membranous nephropathy and IgA nephropathy further emphasized the distinctive pathology of HBV-related glomerulonephritis and the independent etiological role of HBeAg and HBsAg. In other glomerulonephritis, which rarely demonstrated glomerular HBV antigens, the pathogenetic role of chronic HBV infection remains to be proven.
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PMID:Primary glomerulonephritis with detectable glomerular hepatitis B virus antigens. 829 56

A retrospective review was undertaken on all renal biopsies performed in Chinese children under 13 years of age in Queen Mary Hospital, Hong Kong from 1980 to 1990. Of 172 renal biopsies, 18 cases were diagnosed to be membranous glomerulonephritis. All were associated with hepatitis B virus infection. Fourteen patients presented with, and 3 others developed later nephrotic syndrome. Hematuria was a common feature (83%). Complement C3 was low in 5 cases and they became normal later. At last observation, 10 patients (59%) remitted, usually within 3 years. One had persistent proteinuria and 5 had nephrotic syndrome. One patient developed end-stage renal failure 12 years after onset of illness. All three female patients completely remitted. Of the 15 boys, 50% remitted whether they received steroid treatment or not. Two patients received interferon alpha-2a therapy. One achieved remission but HBsAg and HBeAg persisted. The other had transient seroconversion and clinical improvement but nephrotic syndrome returned after stopping treatment.
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PMID:Hepatitis B virus associated membranous glomerulonephritis in children--experience in Hong Kong. 840 68

In order to investigate the role of hepatitis B virus (HBV) DNA in the pathogenesis of renal lesion in HBV-associated membranous nephropathy (HBVMN) patients, serial studies using an in situ hybridization technique at different time points were performed. Within 6 months after the onset of the disease, 7 of 8 (87.5%) HBVMN patients demonstrated HBV DNA in the glomeruli and tubular epithelia. In contrast to the 14 HBVMN specimens taken later than 6 months after the onset, HBV DNA was detectable in only 3 (21%) in the tubular epithelia but none in the glomerular region. Most of the glomeruli-associated HBV DNA seemed extracellular because they were also positive for both the accumulation of HB e antigen (HBeAg)-anti-HBe antibody (Ab) immune complex and immunoglobulin G. The finding suggested that glomeruli-associated viral DNA is joined with filtered HBeAg-anti-HBeAb immune complexes. In the analysis of follow-up biopsies, HBV DNA in tubular epithelia was detected more frequently in the progressive group (50%) than in the nonprogressive group (0%). HBV DNA was detectable in the tubular epithelia in 2 cases who were progressing to end-stage renal disease and had heavy proteinuria. However, in the cases with mild or no proteinuria, HBV DNA was no longer detectable in the kidney. These findings suggest that HBV disseminates in the kidney and its dynamic changes at different time points may implicate the important role of HBV in the pathogenesis of HBVMN. This needs further study to be clarified.
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PMID:Hepatitis B virus deoxyribonucleic acid in kidney cells probably leading to viral pathogenesis among hepatitis B virus associated membranous nephropathy patients. 844 53

In order to appreciate the frequency of hepatitis B virus (HBV) infection in patients with glomerular diseases in France, a low endemic country, we reviewed the series of patients biopsied in the years 1983-1989 in 2 departments of nephrology differing by the characteristics of the population. In Saint-Brieuc, where the population is almost exclusively Caucasian, with nearly no immigrant, HBsAg was not detected in any of the 86 patients. In Paris, a large number of patients come from highly or intermediately endemic regions. HBsAg was detected in 3 of 209 patients, 2 of the 75 patients with membranous nephropathy and 1 of the 32 patients with minimal-change nephrotic syndrome. These patients came from Africa and Asia. Therefore, in low endemic countries, the role of HBV infection in the etiology of glomerulonephritis is minimal. But, because of the late severity of the disease, screening remains essential in patients belonging to the high-risk groups.
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PMID:How frequent are hepatitis B virus markers in adult patients with glomerular diseases in a low endemic country? A French study from Paris and Saint-Brieuc. 845 74

To investigate the role of hepatitis B virus in the pathogenesis of membranous nephropathy (MN) in China, we studied 67 MN patients (excluding lupas nephritis V) with immunoperoxidase technique. In 46 (68.2%) of the 67 MN patients, HBV antigens (HBsAg, HBcAg and HBeAg) were detected in their glomeruli, and HBsAg, the dominant antigen was detected in 45 patients (67.2%). HBV-Ag was detected less frequently in the older MN group (33.3%) (> 50 years old) than in the two younger MN groups (73.1%, 75%) (< 30 years old, 30-50 years old) (P < 0.05). 30 randomly selected MsPGN patients were studied as controls. HBV antigens were detected in only 3 out of the 30 MsPGN patients. The HBV antigen positivity rate of the MN group was significantly higher than that of the MsPGN group (P < 0.01). The results suggested that HBV may be the main cause of MN in China, especially in those younger than 50 years, but not of MsPGN. HBsAg containing immune complexs (IC) may play an important role in the pathogenesis of HBV-MN.
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PMID:[Hepatitis B virus, the main cause of membranous nephropathy in China]. 855 45


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