Meta-analysis: anti-viral therapy of hepatitis B virus-associated glomerulonephritis

Aliment Pharmacol Ther. 2006 Sep 1;24(5):781-8. doi: 10.1111/j.1365-2036.2006.03041.x.


Background: Hepatitis B virus-associated glomerulonephritis is an infrequent complication of chronic hepatitis B virus (HBV) with significant morbidity. A causal association between hepatitis B virus infection and the development of glomerulonephritis remains controversial. Also, the optimal therapy is undefined although several approaches have been made.

Aim: To evaluate the efficacy and safety of anti-viral therapy (interferon or lamivudine) in HBV-associated glomerulonephritis by a systematic review and meta-analysis of clinical trials.

Methods: The primary outcome was clinical response (as a measure of efficacy); the secondary outcomes were drop-out rate (as a measure of tolerability), and virological response. We used the random effects model of DerSimonian and Laird, with heterogeneity, sensitivity and meta-regression analyses.

Results: We identified six clinical trials (84 unique patients); three had controlled design. The overall estimate for proteinuria remission was 65.2% (95% confidence intervals: 52.7-75.9%), Q-test for heterogeneity = 7.731, P = 0.172, I(2) = 35.327. The overall estimate for hepatitis B e antigen clearance was 62.0% (95% confidence intervals: 50.5-72.2%). The overall estimate for drop-out rate was 12.7% (95% confidence intervals: 6.4-23.6%). Meta-regression analysis showed a significant link between hepatitis B e antigen clearance and logit rate of proteinuria remission after interferon therapy [coefficient -2.585 (S.E. 1.089), P = 0.017].

Conclusion: Remission of the nephrotic syndrome is accompanied by clearance of HBV replication, supporting the role of the virus in the pathogenesis of the disease.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Anti-HIV Agents / therapeutic use
  • Antiviral Agents / therapeutic use*
  • Clinical Trials as Topic
  • Female
  • Glomerulonephritis / drug therapy*
  • Glomerulonephritis / virology
  • Hepatitis B Antigens / analysis
  • Hepatitis B, Chronic / complications*
  • Hepatitis B, Chronic / drug therapy
  • Humans
  • Interferons / therapeutic use*
  • Lamivudine / therapeutic use*
  • Male
  • Nephrotic Syndrome / drug therapy
  • Nephrotic Syndrome / virology
  • Patient Dropouts
  • Treatment Outcome


  • Anti-HIV Agents
  • Antiviral Agents
  • Hepatitis B Antigens
  • Lamivudine
  • Interferons