title: Clinical and pathological characteristics of 5 children with HBV surface antigen (HBsAg)-negative hepatitis B virus-associated glomerulonephritis.
abstract: BACKGROUND
  Hepatitis B virus-associated glomerulonephritis (HBV-GN) mainly occurs in children. Patients with HBV-GN are frequently positive for serum HBV surface antigen (HBsAg), but they are rarely negative.
  
  
  OBJECTIVE
  To explore the clinical and pathological characteristics of patients with HBV-GN who are serum HBsAg negative.
  
  
  METHODS
  Five children with HBV-GN who are negative for HBsAg were included in this study. Their clinical and pathological characteristics were collected and analyzed.
  
  
  RESULTS
  All 5 children presented with different levels of proteinuria and microscopic hematuria. Renal biopsies showed membranous nephropathy accompanied by HBsAg and/or HBcAg deposits in glomeruli in all of the children. Steroids and/or other immunosuppressants were administered in all cases without antiviral therapy during the early stages of treatment. Two children achieved complete remission but relapsed after the drugs were tapered down. The other 3 children were initially non-responsive but achieved remission after lamivudine was added.
  
  
  CONCLUSIONS
  Treatment of HBsAg-negative HBV-GN patients with immunosuppressants alone could not achieve satisfactory effects. Antiviral treatment is effective and may be necessary in this type of patient.
authors: Children's Kidney Disease Center, Department of Pediatrics, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
authors: Ting
authors: T
authors: Liu
authors: Department of Pathology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
authors: Shicong
authors: S
authors: Yang
authors: Children's Kidney Disease Center, Department of Pediatrics, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
authors: Zhihui
authors: Z
authors: Yue
authors: Department of Clinical Laboratory, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
authors: Yu
authors: Y
authors: Kuang
authors: Department of Pathology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
authors: Weiming
authors: W
authors: Guan
authors: Children's Kidney Disease Center, Department of Pediatrics, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China. Electronic address: sunlzh@mail.sysu.edu.cn.
authors: Liangzhong
authors: L
authors: Sun
mesh_terms: D000293:Adolescent; D000998:Antiviral Agents / Q000627:therapeutic use; D002648:Child; D005260:Female; D005921:Glomerulonephritis / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology*; D006417:Hematuria / Q000175:diagnosis / Q000473:pathology; D006509:Hepatitis B / Q000150:complications*; D006514:Hepatitis B Surface Antigens / Q000032:analysis / Q000097:blood*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007668:Kidney / Q000473:pathology / Q000821:virology; D007678:Kidney Glomerulus / Q000473:pathology / Q000821:virology; D008297:Male; D011507:Proteinuria / Q000175:diagnosis / Q000473:pathology; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D006514:Hepatitis B Surface Antigens; D007166:Immunosuppressive Agents
keywords: Glomerulonephritis; Hepatitis B virus; Immunosuppressant; Membranous nephropathy; Surface antigen