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Hepatitis B-related glomerulonephritis and optimization of treatment.

Authors :
Liu, Yanjun
Shi, Cuicui
Fan, Jiangao
Wang, Baocan
Li, Guangming
Source :
Expert Review of Gastroenterology & Hepatology; Feb2020, Vol. 14 Issue 2, p113-125, 13p
Publication Year :
2020

Abstract

Introduction: Multiple studies have revealed a strong relationship between the development of nephropathy and hepatitis B virus (HBV) infection. The underlying pathogenesis of hepatitis B-related glomerulonephritis (HBV-GN) involves immune complexes, which can be isolated from kidney tissues. Clearance of HBV antigenemia improves renal impairment and proteinuria in HBV-GN patients. Areas covered: In this review, we present our current understanding of the epidemiology, pathogenesis, pathology, diagnosis, and treatment of HBV-GN. We discuss the advantages and disadvantages of oral nucleoside/nucleotide analogs (NAs), and the main pharmaceutical treatment for hepatis B. Expert opinion: Currently, antiviral agents are the main HBV-GN therapeutic agents. Although no randomized controlled clinical trials have compared the efficacy of interferon (IFN) and NA, we suggest IFN treatment for pediatric patients (IFN-α in patients ≥1 year; pegIFN-α in patients ≥3 years) considering treatment duration and absence of resistance. Novel NAs have brought about promising treatment options involving high efficacy viral suppression and low resistance rates. NAs with a high barrier to resistance (e.g. entecavir) are recommended as first-line therapy of HBV-GN. Immunosuppression monotherapy, such as corticosteroids, is of little benefit and potentially harmful to HBV-GN patients due to the possibility of viral reactivation. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
17474124
Volume :
14
Issue :
2
Database :
Complementary Index
Journal :
Expert Review of Gastroenterology & Hepatology
Publication Type :
Academic Journal
Accession number :
141876908
Full Text :
https://doi.org/10.1080/17474124.2020.1717948