Remission of nephrotic syndrome of HBV-associated membranous glomerulopathy following treatment with interferon.
We report a 26-year-old homosexual man who developed membranous glomerulopathy with nephrotic syndrome secondary to hepatitis B virus infection and HBe antigenemia. Aminotransferase levels were minimally abnormal, and a liver biopsy showed mild chronic 'persistent' hepatitis. He was initially treated for 4 weeks with human lymphoblastoid alpha-interferon by subcutaneous injection without effect. A second 4-week course of interferon in combination with acyclovir also failed to eradicate HBeAg from the circulation or to reduce the proteinuria. Four years later, he developed new symptomatic hepatitis, with plasma aminotransferases elevated to 200-300 IU/l for more than 4 months. Treatment with interferon was again initiated, and by the 4th month of therapy, he had seroconverted to anti-e status, and cleared the HBeAg from circulation. At the same time, proteinuria significantly dropped from an average of 7 g/day to less than 0.5 g/day. Four years after completion of interferon treatment, he became HBsAg negative and anti-HBsAg reactive while remaining persistently HBeAg negative and anti-HBe positive. He has been free of edema, with normal renal and hepatic function, and his 24-hour protein excretion was less than 0.12 g/day.
Shapiro
R J
RJ
Department of Medicine, University Hospital, University of British Columbia, Vancouver, Canada.
Steinbrecher
U P
UP
Magil
A
A
D000328:Adult; D015433:Glomerulonephritis, Membranous / Q000150:complications / Q000628:therapy* / Q000821:virology; D006509:Hepatitis B / Q000150:complications*; D006801:Humans; D007372:Interferons / Q000627:therapeutic use*; D008297:Male; D009404:Nephrotic Syndrome / Q000209:etiology / Q000628:therapy*; D012074:Remission Induction
D007372:Interferons