title: Combination therapy with lamivudine and angiotensin-converting enzyme inhibitor/angiotensin receptor blocker for hepatitis B virus-associated glomerulonephritis with mild to moderate proteinuria: a clinical review of 38 cases.
abstract: OBJECTIVE
  The treatment of HBV-associated glomerulonephritis (HBV-GN) is still a challenge in clinical practice now. The objective of this study was to report the pathological characteristics of HBV-GN presenting with mild to moderate proteinuria and to evaluate the therapeutic efficacy of lamivudine (LAM) in combination with angiotensin-converting enzyme inhibitor (ACEI)/angiotensin receptor blocker (ARB) as compared to ACEI/ARB monotherapy.
  
  
  METHODS
  We conducted a retrospective observational study in HBV-GN patients between 2005 and 2014. The patients were classified into two groups: Group 1 included patients treated with LAM plus ACEI/ARB (n = 20), and group 2, patients treated with ACEI/ARB alone (n = 18). Their clinical and pathological characteristics were collected; we analyzed the therapeutic responses and assessed the correlation between renal and liver pathologies.
  
  
  RESULTS
  Our results showed that the most common type of HBV-GN was IgA nephropathy. LAM plus ACEI/ARB therapy was better in reducing 24-h urinary protein excretion, alanine aminotransferase, and aspartate aminotransferase levels, while maintaining the level of kidney function. The proportion of patients who achieved remission (CR + PR) was higher in the LAM plus ACEI/ARB group than in the ACEI/ARB monotherapy group (χ2= 5.371, P = 0.035).
  
  
  CONCLUSIONS
  In the HBV-GN patients with mild to moderate proteinuria, LAM plus ACEI/ARB not only improved liver function but also better reduced 24-h proteinuria.
authors.affiliation: Department of Nephrology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, 200092, China. sunlijing68@163.com.|Department of Nephrology, Changhai Hospital Affiliated to the Second Military Medical University, Shanghai, 200433, China. sunlijing68@163.com.
authors.forename: Li-Jing
authors.initials: LJ
authors.lastname: Sun
authors.affiliation: Department of Nephrology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, 200092, China.
authors.forename: Jian-Ping
authors.initials: JP
authors.lastname: Shan
authors.affiliation: Department of Nephrology, Changhai Hospital Affiliated to the Second Military Medical University, Shanghai, 200433, China.
authors.forename: Ruo-Lan
authors.initials: RL
authors.lastname: Cui
authors.affiliation: Department of Nephrology, Changhai Hospital Affiliated to the Second Military Medical University, Shanghai, 200433, China.
authors.forename: Wei-Jie
authors.initials: WJ
authors.lastname: Yuan
authors.affiliation: Department of Nephrology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, 200092, China.
authors.forename: Geng-Ru
authors.initials: GR
authors.lastname: Jiang
mesh_terms: D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D057911:Angiotensin Receptor Antagonists / Q000627:therapeutic use*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D001219:Aspartate Aminotransferases / Q000097:blood; D004359:Drug Therapy, Combination; D005260:Female; D005921:Glomerulonephritis / Q000150:complications / Q000473:pathology / Q000821:virology*; D019694:Hepatitis B, Chronic / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D019259:Lamivudine / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011507:Proteinuria / Q000209:etiology; D012189:Retrospective Studies; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use*
chemical_list: D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D018894:Reverse Transcriptase Inhibitors; D019259:Lamivudine; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase
keywords: ACEI; ARB; HBV-associated glomerulonephritis; Lamivudine; Therapeutic efficacy