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
Background:Hepatitis B virus-associated glomerulonephritis(HBV-GN)is one of the extrahepatic manifestations after HBV infection,which would cause great clinical harm to people.The present study was undertaken to inves...Background:Hepatitis B virus-associated glomerulonephritis(HBV-GN)is one of the extrahepatic manifestations after HBV infection,which would cause great clinical harm to people.The present study was undertaken to investigate the HBV-GN genotypes and its clinical relevance in Chinese children.Methods:A total of 41 HBV-infected children diagnosed with HBV-GN were enrolled in the study.All patients underwent liver and kidney biopsy.The genotypes and cccDNA were detected in their serum samples to analyze the relationship between HBV genotypes and clinical characteristics,cccDNA,and pathology.Results:Among the 41 children with HBV-GN,29(70.7%)had genotype C,10(24.4%)had genotype B,2(4.9%)had genotype B/C,and none of them had genotype non-B/C.Most children had genotypes B or C;moreover,the genotype C was the most frequent one.The incidence of hematuria and albuminuria,reduction in complement C3,increase in serum alanine aminotransferase levels and renal insufficiency in the children with genotype C were signifi cantly higher than those in the children with genotype B(P<0.05);however,there was no statistically significant difference in hypertension and hepatomegaly(P>0.05).The frequency of HBV cccDNA positive in the genotype C group was significantly higher than that in the genotype B group(72.4%vs.30.0%,P<0.05).No difference was observed in hepatic inflammation grades and stages of fibrosis between the two groups(P>0.05).Conclusion:Genotype C was the most frequent genotype in the described group of patients with HBV-GN,and the liver and kidney damage indicators were more likely to occur in patients with genotype C.展开更多
Objective To study the pathogenesis of hepatitis B virus ( HBV ) on kidney tissues. Methods HBsAg and HBcAg in paraffin-embedded renal biopsy tissues from 27 cases of glomerulonephritis with positive serum HBV markers...Objective To study the pathogenesis of hepatitis B virus ( HBV ) on kidney tissues. Methods HBsAg and HBcAg in paraffin-embedded renal biopsy tissues from 27 cases of glomerulonephritis with positive serum HBV markers were observed by using immunohistochemistry. In addition, in situ polymerse chain reaction (IS-PCR) was performed in 5 cases with positive HBsAg and HBcAg in renal tissue of the 27-case glomerulonephritis to reveal the state of renal HBV DNA. Results Twenty cases (20/27,74.07%) were positive with HBAg which were mainly diffusely distributed in epithelial cells of renal tubule. Four cases (4/5,80% ) were positive with HBV DNA whose distribution was the same of that of HBAg. Conclusion Renal lesions due to HBV are not only the results of immunologic response, but also the outcome of direct invasion and duplication of HBV in epithelial cells of renal tubule.展开更多
Hepatitis C virus (HCV) infection is a systemic disorder which is often associated with a number of extrahepatic manifestations including glomerulopathies. Patients with HCV infection were found to have a higher risk ...Hepatitis C virus (HCV) infection is a systemic disorder which is often associated with a number of extrahepatic manifestations including glomerulopathies. Patients with HCV infection were found to have a higher risk of end-stage renal disease. HCV positivity has also been linked to lower graft and patient survivals after kidney transplantation. Various histological types of renal diseases are reported in association with HCV infection including membranoproliferative glomerulonephritis (MPGN), membranous nephropathy, focal segmental glomerulosclerosis, fibrillary glomerulonephritis, immunotactoid glomerulopathy, IgA nephropathy, renal thrombotic microangiopathy, vasculitic renal involvement and interstitial nephritis. The most common type of HCV associated glomerulopathy is type I MPGN associated with type II mixed cryoglobulinemia. Clinically, typical renal manifestations in HCV-infected patients include proteinuria, microscopic hematuria, hypertension, acute nephritis and nephrotic syndrome. Three approaches may be suggested for the treatment of HCV-associated glomerulopathies and cryoglobulinemic renal disease: (1) antiviral therapy to prevent the further direct damage of HCV on kidneys and synthesis of immune-complexes; (2) B-cell depletion therapy to prevent formation of immune-complexes and cryoglobulins; and (3) nonspecific immunosuppressive therapy targeting inflammatory cells to prevent the synthesis of immune-complexes and to treat cryoglobulin associated vasculitis. In patients with moderate proteinuria and stable renal functions, anti-HCV therapy is advised to be started as pegylated interferon-α plus ribavirin. However in patients with nephrotic-range proteinuria and/or progressive kidney injury and other serious extra-renal manifestations, immunosuppressive therapy with cyclophosphamide, rituximab, steroid pulses and plasmapheresis should be administrated.展开更多
A synthetic oligonucleotide, HSD-2a, encoding a peptide segment of the extracel-lular domain of a human sperm membrane protein, YWK-II, was fused with hepatitisB surface antigen gene (HBs gene ). The fused gene was th...A synthetic oligonucleotide, HSD-2a, encoding a peptide segment of the extracel-lular domain of a human sperm membrane protein, YWK-II, was fused with hepatitisB surface antigen gene (HBs gene ). The fused gene was then cloned to pUC18plasmid. The fused gene was prepared from the recombinant pUC18 plasmid byBamH I and Eco R I digestion, and then cloned into the transfer vector pGJP- 5 underthe control of P;., promoter, designated as pGJP-HSD/HBs. CV-1 cells were co-transfected with vaccinia virus (Tian Tan strain) and pGJP-HSD/IIBs and homolo-gous re combination occurred between the vaccinia virus TK gene of the plasmid flank-ing the foreign gene and the same sequences within the virus genome. TK phen0tyPerecombinant virus, vv-HSD/HBs, were selected from trandected HuTK' cells byplaque purthcation technique. The eopressi0n of HSD-b in spent medium and cellu-lar protein of HuTK cells infected with vv-HSD/HBs was determined by ELISAand Western-blot analysis using anti-rwK-II antiserum. The present study indicatesthat the vv-HSD/HBs seems promising as an antdertility vaccine.展开更多
目的探讨HBV相关性肾炎(hepatitis B virus associated glomerulonephritis,HBV-GN)易感性与维生素D受体(vitamin D receptor,VDR)基因BsmⅠ及FokⅠ酶切位点多态性的关系。方法应用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)分析技...目的探讨HBV相关性肾炎(hepatitis B virus associated glomerulonephritis,HBV-GN)易感性与维生素D受体(vitamin D receptor,VDR)基因BsmⅠ及FokⅠ酶切位点多态性的关系。方法应用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)分析技术检测VDR基因BsmⅠ及FokⅠ的多态性在40例HBV-GN患者、34例慢性乙肝患者及46例健康对照者中的分布,并进行基因型分析。结果 HBV-GN组FF基因型分布明显低于正常对照组及慢性乙肝组(χ2=9.084、10.254,P=0.0025、0.0014),HBV-GN组F/f等位基因频率分布和对照组及慢性乙肝组比较无统计学意义(P>0.05);慢性乙肝组FokⅠ位点基因型和等位基因频率分布与正常对照组比较差异不显著(P>0.05)。HBV-GN组和乙型肝炎组Bb基因型分布明显高于正常对照组(χ2=8.9451、0.435,P=0.0027、0.0012),两组B等位基因分布明显高于对照组(χ2=7.9001、0.329,P=0.00490、.0013);HBV-GN和慢性乙肝组间比较差异不显著。结论 VDR基因多态性可能与乙肝相关性肾炎及HBV感染相关联。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This study was supported by grants from the Natural Science Foundation of Gansu Province(1308RJZA297)the Natural Science Foundation of Gansu Province(099RJYA001)+1 种基金Department of Science,Technology and Education of Health Ministry Project(201002006)Science and Technology Support Plan of Gansu Province(1104FKCA159).
文摘Background:Hepatitis B virus-associated glomerulonephritis(HBV-GN)is one of the extrahepatic manifestations after HBV infection,which would cause great clinical harm to people.The present study was undertaken to investigate the HBV-GN genotypes and its clinical relevance in Chinese children.Methods:A total of 41 HBV-infected children diagnosed with HBV-GN were enrolled in the study.All patients underwent liver and kidney biopsy.The genotypes and cccDNA were detected in their serum samples to analyze the relationship between HBV genotypes and clinical characteristics,cccDNA,and pathology.Results:Among the 41 children with HBV-GN,29(70.7%)had genotype C,10(24.4%)had genotype B,2(4.9%)had genotype B/C,and none of them had genotype non-B/C.Most children had genotypes B or C;moreover,the genotype C was the most frequent one.The incidence of hematuria and albuminuria,reduction in complement C3,increase in serum alanine aminotransferase levels and renal insufficiency in the children with genotype C were signifi cantly higher than those in the children with genotype B(P<0.05);however,there was no statistically significant difference in hypertension and hepatomegaly(P>0.05).The frequency of HBV cccDNA positive in the genotype C group was significantly higher than that in the genotype B group(72.4%vs.30.0%,P<0.05).No difference was observed in hepatic inflammation grades and stages of fibrosis between the two groups(P>0.05).Conclusion:Genotype C was the most frequent genotype in the described group of patients with HBV-GN,and the liver and kidney damage indicators were more likely to occur in patients with genotype C.
基金ThisworkwassupportedbytheNaturalScienceFoundationofShaanxiProvince (No .2 0 0 0SM48) .
文摘Objective To study the pathogenesis of hepatitis B virus ( HBV ) on kidney tissues. Methods HBsAg and HBcAg in paraffin-embedded renal biopsy tissues from 27 cases of glomerulonephritis with positive serum HBV markers were observed by using immunohistochemistry. In addition, in situ polymerse chain reaction (IS-PCR) was performed in 5 cases with positive HBsAg and HBcAg in renal tissue of the 27-case glomerulonephritis to reveal the state of renal HBV DNA. Results Twenty cases (20/27,74.07%) were positive with HBAg which were mainly diffusely distributed in epithelial cells of renal tubule. Four cases (4/5,80% ) were positive with HBV DNA whose distribution was the same of that of HBAg. Conclusion Renal lesions due to HBV are not only the results of immunologic response, but also the outcome of direct invasion and duplication of HBV in epithelial cells of renal tubule.
文摘Hepatitis C virus (HCV) infection is a systemic disorder which is often associated with a number of extrahepatic manifestations including glomerulopathies. Patients with HCV infection were found to have a higher risk of end-stage renal disease. HCV positivity has also been linked to lower graft and patient survivals after kidney transplantation. Various histological types of renal diseases are reported in association with HCV infection including membranoproliferative glomerulonephritis (MPGN), membranous nephropathy, focal segmental glomerulosclerosis, fibrillary glomerulonephritis, immunotactoid glomerulopathy, IgA nephropathy, renal thrombotic microangiopathy, vasculitic renal involvement and interstitial nephritis. The most common type of HCV associated glomerulopathy is type I MPGN associated with type II mixed cryoglobulinemia. Clinically, typical renal manifestations in HCV-infected patients include proteinuria, microscopic hematuria, hypertension, acute nephritis and nephrotic syndrome. Three approaches may be suggested for the treatment of HCV-associated glomerulopathies and cryoglobulinemic renal disease: (1) antiviral therapy to prevent the further direct damage of HCV on kidneys and synthesis of immune-complexes; (2) B-cell depletion therapy to prevent formation of immune-complexes and cryoglobulins; and (3) nonspecific immunosuppressive therapy targeting inflammatory cells to prevent the synthesis of immune-complexes and to treat cryoglobulin associated vasculitis. In patients with moderate proteinuria and stable renal functions, anti-HCV therapy is advised to be started as pegylated interferon-α plus ribavirin. However in patients with nephrotic-range proteinuria and/or progressive kidney injury and other serious extra-renal manifestations, immunosuppressive therapy with cyclophosphamide, rituximab, steroid pulses and plasmapheresis should be administrated.
文摘A synthetic oligonucleotide, HSD-2a, encoding a peptide segment of the extracel-lular domain of a human sperm membrane protein, YWK-II, was fused with hepatitisB surface antigen gene (HBs gene ). The fused gene was then cloned to pUC18plasmid. The fused gene was prepared from the recombinant pUC18 plasmid byBamH I and Eco R I digestion, and then cloned into the transfer vector pGJP- 5 underthe control of P;., promoter, designated as pGJP-HSD/HBs. CV-1 cells were co-transfected with vaccinia virus (Tian Tan strain) and pGJP-HSD/IIBs and homolo-gous re combination occurred between the vaccinia virus TK gene of the plasmid flank-ing the foreign gene and the same sequences within the virus genome. TK phen0tyPerecombinant virus, vv-HSD/HBs, were selected from trandected HuTK' cells byplaque purthcation technique. The eopressi0n of HSD-b in spent medium and cellu-lar protein of HuTK cells infected with vv-HSD/HBs was determined by ELISAand Western-blot analysis using anti-rwK-II antiserum. The present study indicatesthat the vv-HSD/HBs seems promising as an antdertility vaccine.
文摘目的探讨HBV相关性肾炎(hepatitis B virus associated glomerulonephritis,HBV-GN)易感性与维生素D受体(vitamin D receptor,VDR)基因BsmⅠ及FokⅠ酶切位点多态性的关系。方法应用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)分析技术检测VDR基因BsmⅠ及FokⅠ的多态性在40例HBV-GN患者、34例慢性乙肝患者及46例健康对照者中的分布,并进行基因型分析。结果 HBV-GN组FF基因型分布明显低于正常对照组及慢性乙肝组(χ2=9.084、10.254,P=0.0025、0.0014),HBV-GN组F/f等位基因频率分布和对照组及慢性乙肝组比较无统计学意义(P>0.05);慢性乙肝组FokⅠ位点基因型和等位基因频率分布与正常对照组比较差异不显著(P>0.05)。HBV-GN组和乙型肝炎组Bb基因型分布明显高于正常对照组(χ2=8.9451、0.435,P=0.0027、0.0012),两组B等位基因分布明显高于对照组(χ2=7.9001、0.329,P=0.00490、.0013);HBV-GN和慢性乙肝组间比较差异不显著。结论 VDR基因多态性可能与乙肝相关性肾炎及HBV感染相关联。
