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. 2024 Dec;46(1):2313180.
doi: 10.1080/0886022X.2024.2313180. Epub 2024 Feb 12.

Prevalence and immunopathologic characteristics of seropositive and seronegative hepatitis B virus-associated membranous nephropathy: a retrospective study of 420 biopsy-proven cases

Haitao Lu  1 , Qianqian Xu  1 , Guming Zou  1 , Hongmei Gao  1 , Yue Yang  1 , Wenge Li  1 , Li Zhuo  1
Affiliations

Prevalence and immunopathologic characteristics of seropositive and seronegative hepatitis B virus-associated membranous nephropathy: a retrospective study of 420 biopsy-proven cases

Haitao Lu et al. Ren Fail. 2024 Dec.

Abstract

Background: This retrospective study aims to investigate the prevalence and immunopathologic characteristics of seropositive and seronegative hepatitis B virus-associated membranous nephropathy (HBV-MN).

Methods: Clinicopathologic and serologic records of 420 patients with histologically confirmed HBV-MN between January 2014 and July 2021 were examined to determine the prevalence of seropositive and seronegative HBV-MN. Serum anti-PLA2R antibody testing was conducted on 280 patients with HBV-associated membranous nephropathy (HBV-MN) from August 2018 to July 2021. Immunopathologic characteristics of HBV-MN patients and anti-PLA2R antibody positivity were analyzed.

Results: Among 420 pathologically confirmed HBV-MN patients, 230 (54.8%) were seropositive for HBV. The seropositive group exhibited higher blood creatinine values and incidence of liver function abnormalities than the seronegative group (p < .05). Serum anti-PLA2R antibody testing on 280 HBV-MN patients revealed a total positive rate of 44.6%, with the seronegative group showing a significantly higher rate (62.6%) compared to the seropositive group (32.1%) (p < .01). The anti-PLA2R antibody-positive group displayed higher levels of urine protein (p < .05), serum cholesterol (p < .01), and IgG4 subtypes (p < .05) compared to the negative group. Additionally, the positive group had significantly lower levels of serum albumin and IgG than the negative group (p < .01).

Conclusions: This comprehensive study reveals a significantly higher prevalence of seronegative HBV-MN than previously thought. The blood creatinine values and incidence of liver function abnormalities was higher in the serology-positive group than in the serology-negative group. Notably, the seronegative group displayed a higher positive rate of anti-PLA2R antibodies compared to the seropositive group, indicating distinctive clinical and immunopathologic features.

Keywords: HBV-associated membranous nephropathy (HBV-MN); Hepatitis B virus; anti-phospholipase A2 receptor antibody; membranous nephropathy (MN); seroprevalence.

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Conflict of interest statement

No potential conflict of interest was reported by the author(s).

Figures

Figure 1.
Figure 1.
The study flowchart. GN: glomerulonephritis; HBV, hepatitis B virus; MN: membranous nephropathy.
Figure 2.
Figure 2.
Detection of viral antigens and particles in renal tissues. Immunohistochemical staining of frozen renal tissue sections. (A) HBsAg and (B) HBcAg antigens are located in the glomeruli as indicated by brown staining in the glomeruli.
See this image and copyright information in PMC

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