Long-term outcome of hepatitis B virus-related glomerulonephritis after therapy with interferon alfa.
OBJECTIVE
Glomerulonephritis is an uncommon complication of chronic hepatitis B virus (HBV) infection in adults. A high percentage of patients seem to have short-term response to interferon therapy with improvement of proteinuria. The aim of this study was to assess the long-term response of patients with HBV-related glomerulonephritis to interferon alfa therapy.


METHODS
All patients with chronic hepatitis B and glomerulonephritis who were treated with interferon alfa at the National Institutes of Health between 1985 and 1993 were assessed.


RESULTS
Of the 15 patients treated, 8 (53%) had a long-term serological response with sustained loss of serum hepatitis B e antigen and HBV DNA. After 1-7 years of follow-up, all 8 responders have normal serum aminotransferase levels and 5 are hepatitis B surface antigen negative. Seven of the responders also showed a gradual but marked improvement in proteinuria. In contrast, the 7 nonresponders continued to have evidence of active renal disease and 1 required long-term dialysis therapy. All 8 responders had membranous glomerulonephritis, whereas 4 of 7 nonresponders had membranoproliferative glomerulonephritis.


CONCLUSIONS
Interferon alfa therapy resulted in long-term remission in liver disease in 8 of 15 patients with chronic hepatitis B and glomerulonephritis. This response was accompanied by significant improvement in markers of renal disease in the majority of patients.
Conjeevaram
H S
HS
Liver Diseases Section, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA.
Hoofnagle
J H
JH
Austin
H A
HA
Park
Y
Y
Fried
M W
MW
Di Bisceglie
A M
AM
D000328:Adult; D000368:Aged; D002908:Chronic Disease; D004247:DNA / Q000097:blood; D004259:DNA-Directed DNA Polymerase / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D005921:Glomerulonephritis / Q000097:blood / Q000628:therapy* / Q000821:virology; D006509:Hepatitis B / Q000097:blood / Q000628:therapy*; D006513:Hepatitis B e Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000302:isolation & purification; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D000637:Transaminases / Q000097:blood
D006513:Hepatitis B e Antigens; D016898:Interferon-alpha; D004247:DNA; D000637:Transaminases; D004259:DNA-Directed DNA Polymerase