AIM:To evaluate the efficacy of antiviral or corticosteroid treatment on hepatitis B virus-associated glomerulonephritis(HBV-GN) . METHODS:Six and five trials were used respectively to evaluate the efficacy of either ...AIM:To evaluate the efficacy of antiviral or corticosteroid treatment on hepatitis B virus-associated glomerulonephritis(HBV-GN) . METHODS:Six and five trials were used respectively to evaluate the efficacy of either antiviral or corticosteroid treatment on HBV-GN.Pediatric patients were pooled separately to assess their response to the above treatment modalities.The primary and secondary outcomes were remission of proteinuria and clearance of Hepatitis B e-antigen(HBeAg) ,respectively.A fixed or random effect model was established to collect the data. RESULTS:The remission rate of proteinuria(RR=1.69,95%CI:1.08-2.65) and the clearance rate of HBeAg(RR =6.44,95%CI:3.11-13.35) were significantly higher in antiviral treatment group than in control group.The proteinuria remission was significantly associated with HBeAg clearance(P=0.002) .However,the difference in proteinuria remission rate was not statistically significant between corticosteroid treatment group and controlgroup(RR=1.45,95%CI:0.68-3.11) .Antiviral therapy could significantly promote the HBeAg clearance in pediatric patients,but neither antiviral nor corticosteroid therapy could significantly decrease proteinuria in pediatric patients compared to controls. CONCLUSION:Antiviral but not corticosteroid treatment can decrease proteinuria and promote HBeAg clearance in HBV-GN patients.展开更多
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, accor...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.展开更多
乙肝病毒相关性肾炎(hepatitisBvirus-associated glomerular nephritis,HBV-GN)是指由乙型肝炎病毒(hepatitis B virus,HBV)直接或间接诱发的肾小球肾炎,中国是乙型肝炎的高发国家。据数据统计,中国成年人HBV携带率高达10%以上,其中HBV...乙肝病毒相关性肾炎(hepatitisBvirus-associated glomerular nephritis,HBV-GN)是指由乙型肝炎病毒(hepatitis B virus,HBV)直接或间接诱发的肾小球肾炎,中国是乙型肝炎的高发国家。据数据统计,中国成年人HBV携带率高达10%以上,其中HBV-GN的发生率约为9.0%[1]。针对HBV-GN目前临床尚无特效疗法,单纯核苷酸类似物治疗大量蛋白尿HBV-GN的尿蛋白缓解率低[2],临床疗效并不理想。目前通过糖皮质激素、免疫抑制剂类药物来改善患者的临床症状,控制病情进展,但实践证实,长期应用则会加速HBV复制[3]。近年来,随着临床对HBV-GN研究的不断深入,临床上常应用恩替卡韦进行抗病毒治疗,尽管有效抑制了HBV的复制,但还需联合应用糖皮质激素来减少尿蛋白,控制病情进展[4],但目前激素应用的剂量、疗程未见详细报道。现报道潍坊医学院临床医学院采用小剂量糖皮质激素联合恩替卡韦治疗3例乙肝相关性肾炎的成功案例,现报道如下。展开更多
As obligate intracellular parasites,viruses need a host cell to provide a milieu favorable to viral replication.Consequently,viruses often adopt mechanisms to subvert host cellular signaling processes.While beneficial...As obligate intracellular parasites,viruses need a host cell to provide a milieu favorable to viral replication.Consequently,viruses often adopt mechanisms to subvert host cellular signaling processes.While beneficial for the viral replication cycle,virus-induced deregulation of host cellular signaling processes can be detrimental to host cell physiology and can lead to virus-associated pathogenesis,including,for oncogenic viruses,cell transformation and cancer progression.Included among these oncogenic viruses is the hepatitis B virus(HBV).Despite the availability of an HBV vaccine,350-500 million people worldwide are chronically infected with HBV,and a significant number of these chronically infected individuals will develop hepatocellular carcinoma(HCC).Epidemiological studies indicate that chronic infection with HBV is the leading risk factor for the development of HCC.Globally,HCC is the second highest cause of cancer-associated deaths,underscoring the need for understanding mechanisms that regulate HBV replication and the development of HBV-associated HCC.HBV is the prototype member of the Hepadnaviridae family;members of this family of viruses have a narrow host range and predominately infect hepatocytes in their respective hosts.The extremely small and compact hepadnaviral genome,the unique arrangement of open reading frames,and a replication strategy utilizing reverse transcription of an RNA intermediate to generate the DNA genome are distinguishing features of the Hepadnaviridae.In this review,the authors provide a comprehensive description of HBV biology,summarize the model systems used for studying HBV infections,and highlight potential mechanisms that link a chronic HBV-infection to the development of HCC.For example,the HBV X protein(HBx),a key regulatory HBV protein that is important for HBV replication,is thought to play a cofactor role in the development of HBV-induced HCC,and the authors highlight the functions of HBx that may contribute to the development of HBV-associated HCC.展开更多
目的:回顾性研究血清乙型肝炎病毒DNA(hepatitis B virus DNA,HBV-DNA)载量与乙型肝炎病毒相关性肾炎(hepatitis B virus associated-glomerulonephritis,HBV-GN)肾脏病理演变的相关性。方法:根据血清HBV-DNA载量,将41例HBV-GN患者分为3...目的:回顾性研究血清乙型肝炎病毒DNA(hepatitis B virus DNA,HBV-DNA)载量与乙型肝炎病毒相关性肾炎(hepatitis B virus associated-glomerulonephritis,HBV-GN)肾脏病理演变的相关性。方法:根据血清HBV-DNA载量,将41例HBV-GN患者分为3组,分别为低度复制组、中度复制组、高度复制组。分析其中35例膜性肾病患者病理分期与病毒DNA复制的相关性;根据免疫组织化学染色结果,比较HBV-DNA复制水平对肾组织HBV抗原沉积的影响,以及HBV抗原沉积对膜性肾病病理变化的影响。结果:随着HBV-DNA复制增加,35例膜性肾病患者的肾脏病理损害逐渐加重,DNA定量水平与病理变化之间存在相关性;随着HBV-DNA复制的增加,HBV抗原在肾小球沉积的数量增加;随着HBV抗原沉积的增加,膜性肾病患者的肾脏病理损害加重。结论:随着HBV-DNA复制增多,乙肝病毒抗原成分沉积增多,肾脏病理损害逐渐加重,其变化存在相关性。展开更多
基金Supported by National Natural Science Foundation of China,No.30772360
文摘AIM:To evaluate the efficacy of antiviral or corticosteroid treatment on hepatitis B virus-associated glomerulonephritis(HBV-GN) . METHODS:Six and five trials were used respectively to evaluate the efficacy of either antiviral or corticosteroid treatment on HBV-GN.Pediatric patients were pooled separately to assess their response to the above treatment modalities.The primary and secondary outcomes were remission of proteinuria and clearance of Hepatitis B e-antigen(HBeAg) ,respectively.A fixed or random effect model was established to collect the data. RESULTS:The remission rate of proteinuria(RR=1.69,95%CI:1.08-2.65) and the clearance rate of HBeAg(RR =6.44,95%CI:3.11-13.35) were significantly higher in antiviral treatment group than in control group.The proteinuria remission was significantly associated with HBeAg clearance(P=0.002) .However,the difference in proteinuria remission rate was not statistically significant between corticosteroid treatment group and controlgroup(RR=1.45,95%CI:0.68-3.11) .Antiviral therapy could significantly promote the HBeAg clearance in pediatric patients,but neither antiviral nor corticosteroid therapy could significantly decrease proteinuria in pediatric patients compared to controls. CONCLUSION:Antiviral but not corticosteroid treatment can decrease proteinuria and promote HBeAg clearance in HBV-GN patients.
基金supported by the Education Department of Shandong Province,China,No.J11LF21
文摘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.
文摘乙肝病毒相关性肾炎(hepatitisBvirus-associated glomerular nephritis,HBV-GN)是指由乙型肝炎病毒(hepatitis B virus,HBV)直接或间接诱发的肾小球肾炎,中国是乙型肝炎的高发国家。据数据统计,中国成年人HBV携带率高达10%以上,其中HBV-GN的发生率约为9.0%[1]。针对HBV-GN目前临床尚无特效疗法,单纯核苷酸类似物治疗大量蛋白尿HBV-GN的尿蛋白缓解率低[2],临床疗效并不理想。目前通过糖皮质激素、免疫抑制剂类药物来改善患者的临床症状,控制病情进展,但实践证实,长期应用则会加速HBV复制[3]。近年来,随着临床对HBV-GN研究的不断深入,临床上常应用恩替卡韦进行抗病毒治疗,尽管有效抑制了HBV的复制,但还需联合应用糖皮质激素来减少尿蛋白,控制病情进展[4],但目前激素应用的剂量、疗程未见详细报道。现报道潍坊医学院临床医学院采用小剂量糖皮质激素联合恩替卡韦治疗3例乙肝相关性肾炎的成功案例,现报道如下。
基金supported by an NIH predoctoral fellowship to RJLthe grant number is F31CA171712.
文摘As obligate intracellular parasites,viruses need a host cell to provide a milieu favorable to viral replication.Consequently,viruses often adopt mechanisms to subvert host cellular signaling processes.While beneficial for the viral replication cycle,virus-induced deregulation of host cellular signaling processes can be detrimental to host cell physiology and can lead to virus-associated pathogenesis,including,for oncogenic viruses,cell transformation and cancer progression.Included among these oncogenic viruses is the hepatitis B virus(HBV).Despite the availability of an HBV vaccine,350-500 million people worldwide are chronically infected with HBV,and a significant number of these chronically infected individuals will develop hepatocellular carcinoma(HCC).Epidemiological studies indicate that chronic infection with HBV is the leading risk factor for the development of HCC.Globally,HCC is the second highest cause of cancer-associated deaths,underscoring the need for understanding mechanisms that regulate HBV replication and the development of HBV-associated HCC.HBV is the prototype member of the Hepadnaviridae family;members of this family of viruses have a narrow host range and predominately infect hepatocytes in their respective hosts.The extremely small and compact hepadnaviral genome,the unique arrangement of open reading frames,and a replication strategy utilizing reverse transcription of an RNA intermediate to generate the DNA genome are distinguishing features of the Hepadnaviridae.In this review,the authors provide a comprehensive description of HBV biology,summarize the model systems used for studying HBV infections,and highlight potential mechanisms that link a chronic HBV-infection to the development of HCC.For example,the HBV X protein(HBx),a key regulatory HBV protein that is important for HBV replication,is thought to play a cofactor role in the development of HBV-induced HCC,and the authors highlight the functions of HBx that may contribute to the development of HBV-associated HCC.
文摘目的:回顾性研究血清乙型肝炎病毒DNA(hepatitis B virus DNA,HBV-DNA)载量与乙型肝炎病毒相关性肾炎(hepatitis B virus associated-glomerulonephritis,HBV-GN)肾脏病理演变的相关性。方法:根据血清HBV-DNA载量,将41例HBV-GN患者分为3组,分别为低度复制组、中度复制组、高度复制组。分析其中35例膜性肾病患者病理分期与病毒DNA复制的相关性;根据免疫组织化学染色结果,比较HBV-DNA复制水平对肾组织HBV抗原沉积的影响,以及HBV抗原沉积对膜性肾病病理变化的影响。结果:随着HBV-DNA复制增加,35例膜性肾病患者的肾脏病理损害逐渐加重,DNA定量水平与病理变化之间存在相关性;随着HBV-DNA复制的增加,HBV抗原在肾小球沉积的数量增加;随着HBV抗原沉积的增加,膜性肾病患者的肾脏病理损害加重。结论:随着HBV-DNA复制增多,乙肝病毒抗原成分沉积增多,肾脏病理损害逐渐加重,其变化存在相关性。
