Clinical and pathological differences between children with various genotypes of hepatitis B virus-associated glomerulonephritis

SUN Yong-Hong; LEI Xiao-Yan; YUAN Hong

doi:10.7499/j.issn.1008-8830.2015.04.016

PDF(1287 KB)

Chinese Journal of Contemporary Pediatrics ›› 2015, Vol. 17 ›› Issue (4) : 371-374. DOI: 10.7499/j.issn.1008-8830.2015.04.016

CLINICAL RESEARCH

Clinical and pathological differences between children with various genotypes of hepatitis B virus-associated glomerulonephritis

SUN Yong-Hong¹, LEI Xiao-Yan¹, YUAN Hong²

Author information +

History +

Abstract

Objective To compare the clinical and pathological features between children with various genotypes of hepatitis B virus-associated glomerulonephritis (HBV-GN). Methods Forty-one children with HBVGN concurrently undergoing liver and renal biopsy were randomly selected. Serum specimens were collected for genotyping and hepatitis B virus (HBV) cccDNA assay. The clinical, pathological, and HBV cccDNA differences between HBV-GN children of various genotypes were analyzed. Results Among the 41 HBV-GN children, 29 (71%) were genotype C, 10 (24%) were genotype B, and 2 (5%) were genotype B/C. The incidence rates of hematuria, albuminuria, complement 3 decrease, alanine transaminase increase, and renal insufficiency in the genotype C group were significantly higher than those in the genotype B group (P<0.05). Similarly, the HBV cccDNA positive rate was significantly higher in the genotype C group than that in the genotype B group. No difference was observed in the distribution of pathological types of renal tissues betwee the two geonotype groups. There were no significant differences in the degrees of hepatic inflammation and fibrosis between the two groups. Conclusions Mainly genotypes C and B occur in children with HBV-GN and the former genotype is dominant. The clinical symptoms of patients with genotype C are more serious than those with genotype B. However, there is no difference in the pathological features between them.

Key words

Hepatitis B virus / Hepatitis B virus related-nephritis / Genotype / Child

Cite this article

EndNote

Ris (Procite)

Bibtex

Download Citations

SUN Yong-Hong, LEI Xiao-Yan, YUAN Hong. Clinical and pathological differences between children with various genotypes of hepatitis B virus-associated glomerulonephritis[J]. Chinese Journal of Contemporary Pediatrics. 2015, 17(4): 371-374 https://doi.org/10.7499/j.issn.1008-8830.2015.04.016

References

[1] Hepatitis B vaccination coverage among adults-United States 2004. Centers for Disease Control and Prevention (CDC)[J]. MMWR Morb Mortal Wkly Rep, 2006, 55(18): 509-511.
[2] Cacoub P, Saadoun D, Bourliere M, et al. Hepatitis B virus genotypes and extrahepatic manifestations[J]. J Hepatol, 2005, 43(5): 764-770.
[3] 孙利, 徐虹, 周利军, 等. 接种乙型肝炎疫苗对儿童乙型肝炎病毒相关性肾炎患病的影响[J]. 中华儿科杂志, 2003, 41(8): 666-669.
[4] Xu G, Huang T. Hepatitis B virus-associated glomerular nephritis in East Asia progress and challenges[J]. Eur J Intern Med, 2011, 22(2): 161-166.
[5] 中华医学会肝病学分会, 中华医学会感染病学分会. 慢性乙肝防治指南[J]. 中国医学前沿杂志, 2011, 3(1): 66-82.
[6] 周万忠, 张瓦利. 乙型肝炎病毒相关性肾炎[J]. 中华内科杂志, 1990, 29(9): 530-533.
[7] 孙永红, 雷晓燕, 杨菊兰, 等. 儿童乙型肝炎血清HBV cccDNA 及病毒基因型研究[J]. 中华流行病杂志, 2011, 32(12): 1247-1249.
[8] Zeng CH, Chen HM, Wang RS, et al. Etiology and clinical characteristics of membranous nephropathy in Chinese patients[J]. Am J Kidney Dis, 2008, 52(4): 691-698.
[9] 何平, 冯国和. 乙型肝炎病毒相关性肾炎中病毒直接损伤肾组织作用机制研究现状[J]. 中华传染病杂志, 2012, 30(2): 123-125.
[10] 孙永红, 陈青锋, 袁宏, 等. 乙型肝炎病毒基因型与临床病理分级分期的关系[J]. 临床荟萃, 2008, 23(8): 566-568.
[11] 雷晓燕, 孙永红, 杨菊兰, 等. 儿童乙型肝炎病毒基因型与临床分度的关系研究[J]. 中国实用儿科杂志, 2011, 26(4): 296-298.
[12] 徐虹. 儿童乙型肝炎病毒相关性肾炎的流行病学[J]. 实用儿科临床杂志, 2008, 23(5): 323-325.
[13] 党西强, 易著文, 何小解, 等. 乙型肝炎病毒相关性肾炎患儿的肝脏病变[J]. 中国当代儿科杂志, 2006, 8(4): 275-278.
[14] 周建华. 肝炎病毒相关性肾炎的发病机制与病理特点[J]. 临床内科杂志, 2010, 27(9): 581-584.
[15] 雷晓燕, 孙永红, 袁宏, 等. 儿童乙型肝炎T 细胞亚群与病毒复制肝功能及组织病理关系研究[J]. 中国实用儿科杂志, 2012, 27(8): 595-598.
[16] Lin CY, Lin CC, Chang GJ, et al. Defect of cell-mediated immune response against Hepatitis B virus: an indication for pathogenesis of Hepatitis-B-associated membranous nephropathy[J]. Nephron, 1997, 76(2): 176-185.
[17] 王志敏, 李志强, 庞自峰, 等. 乙肝病毒相关性肾炎外周血单个核细胞因子的变化及其对大鼠蛋白尿的影响[J]. 中华儿科学杂志, 2001, 39(8): 489-490.