HBV-Associated Postinfectious Acute Glomerulonephritis: A Report of 10 Cases

PLoS One. 2016 Aug 11;11(8):e0160626. doi: 10.1371/journal.pone.0160626. eCollection 2016.

Abstract

Postinfectious acute glomerulonephritis (PIGN) may occur after various bacterial and viral infections. Hepatitis B virus (HBV) infection is a cause of chronic glomerulonephritis. We report here 10 cases (ages 7-20 years-old) of chronic HBV carriers with acute glomerulonephritis, with positive glomerular staining of hepatitis B surface antigen, and detectable presence of HBV DNA in the glomeruli. This form of PIGN, HBV-PIGN, has not been previously identified. To further characterize clinical and pathological features of HBV- PIGN, we selected 10 cases of age-matched non-HBV PIGN for comparison. While both HBV associated PIGN and non-HBV PIGN similarly presented as proteinuria, hematuria, and hypertension, there was a trend of higher acute kidney injury and worsened prognosis in HBV-PIGN. 6 months after the onset, 4 patients with HBV associated PIGN did not show improvement from the disease, whereas all patients with non-HBV PIGN had complete or partial recovery. Pathologically, both HBV associated PIGN and non-HBV PIGN showed typical diffuse glomerular endocapillary proliferation, but HBV associated PIGN differed from classical PIGN with much fewer sub-epithelial glomerular "hump-shape" immune complex depositions. In conclusion, we have identified a novel association of HBV infection with acute glomerulonephritis.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Adolescent
  • Adult
  • Child
  • Female
  • Glomerulonephritis / complications*
  • Glomerulonephritis / pathology
  • Hepatitis B / complications*
  • Humans
  • Kidney Glomerulus / pathology
  • Kidney Glomerulus / ultrastructure
  • Male

Grants and funding

This study was supported by Natural Science grant of Fujian Provincial Department of Science and Technology (2011 to JC and 2012 to FZ [http://xmgl.fjkjt.gov.cn/]). The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.