RelationshipBetween Serum DNAReplication,Clinicopathological Characteristics andPrognosis ofHepatitis BVirus-associated Glomerulonephritis withSevereProteinuria byLamivudinePlus Adefovir Dipivoxil Combination Therapy

Key words: 
• Hepatitis B virus /
• Nephritis /
• Pathology /
• Proteinuria /
• Lamivudine /
• Adefovir dipivoxil

Abstract: ObjectiveTo explore the relationship between HBV DNA and the clinical manifestations, pathological types, injury severity, and prognosis with HBV-GN. Methods102 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. ResultsSeveral findings were demonstrated with the increase of serum HBV DNA: 24-hurine protein excretion, plasma cholesterol, and triglycerides increased significantly (P<0.05), while the plasma level of albumindecreased 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). ConclusionWith the increase of serum HBV DNA, the urine protein excretion and the kidney injury were more severe, and the clinical remission rate was decreased.