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hepatitis B virus associated glomerulonephritis

2017-03-03 14:53

Hepatitis B virus associated glomerulonephritis

Hepatitis B virus associated glomerulonephritis (HBV-GN) was first reported in the lancet in 1971, and it is considered to be an immune complex mediated glomerulonephritis in the antigen antibody of hepatitis B virus.

Chinese, the Asian region is the epidemic area of hepatitis B, hepatitis B surface antigen positive rate had reached 10%, hepatitis B virus infection appear when glomerulonephritis, need for hepatitis B virus associated glomerulonephritis and hepatitis B virus infection with the non kidney disease related to hepatitis B virus identification.

In 1989, the Chinese Journal of internal medicine, the Beijing Forum on HBV-GN standards promulgated: hepatitis B virus associated glomerulonephritis is defined as:

(1) positive serum HBV antigen;

(2) suffer from glomerulonephritis, and can exclude lupus nephritis and other secondary glomerulonephritis;

(3) HBV antigen was found in renal tissue sections

Third of them are the most basic conditions.

2012: Global kidney disease prognosis (KDIGO Chapter 9: Infection-related glomerulonephritis organization) issued the guidelines for the treatment of glomerulonephritis, of which the ninth chapter "infection associated glomerulonephritis" of hepatitis B virus associated glomerulonephritis is described as: HBV-GN including membranous nephropathy (MN), membranoproliferative glomerulonephritis (MPGN), focal segmental sclerosis (FSGS) and IgA nephropathy. Membranous nephropathy is the most common pathological type of HBV-GN in children. The diagnosis of HBV-GN requires the detection of the virus in the blood and excludes other causes of glomerulonephritis. Note that the diagnostic criteria do not emphasize the detection of viral antigens in renal tissue!

In China, if the diagnostic criteria for hepatitis B virus associated glomerulonephritis are relaxed, the incidence of HBV-GN is too high, which actually includes HBV infection, which is associated with non HBV associated glomerulonephritis. Although there is no better way to pide these two cases, the clinic still adhere to the standard diagnostic HBV-GN forum in Beijing. But for the virus positive patients, whether it is HBV-GN, all advocated antiviral treatment. Sometimes, a simple antiviral treatment can make the protein negative.

 

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