Comparative analysis of clinicopathological features in elderly patients with versus without hepatitis B virus antigen deposition in renal tissue / 中华老年医学杂志

ABSTRACT

Objective:To compare and analyze the clinicopathological data of elderly patients with versus without hepatitis B virus(HBV)antigen deposition in renal tissue, and to investigate the clinicopathological features in elderly patients with HBV associated nephritis(HBV-GN).Methods:The clinicopathological data of 33 patients with HBV-GN and 27 patients with hepatitis B and nephritis(HBV-CG)aged ≥60 years in the 90 th Hospital of the United Nations Support Force were retrospectively analyzed and statistically analyzed. Results:(1)Both the HBV-GN and HBV-CG groups were often men[26(78.8%) vs. 21(77.8%)]and had high rate of nephritic syndrome[18(54.5%) vs.15(55.6%)]. And patients in the HBV-GN group had higher incidence of hypertension than that in the HBV-CG group; (2)Membranous nephropathy(MN)was the main pathological type in both groups, and the rate of membrane proliferative glomerulonephritis(MPGN)was more found in the HBV-GN group than the HBV-CG group; (3)The proportion positive HBsAg, HBeAg and HBcAb test resultsand high viral load was significantly higher in the HBV-GN group than that in the HBV-CG group; (4)Multiple immune complex deposits were observed in the renal tissues of HBV-GN group, which was called the phenomenon of "all bright" ; (5)The pathological features in the HBV-GN group showed untypical manifestation of MN, the occasionally observed crescent formation, and the thickening of basement membrane in focal segmental glomerulosclerosis; (6)The incidence and the severity of renal tubule and interstitial lesions in HBV-GN group were significantly higher than those in HBV-CG group. Conclusions:Although there are many similarities in clinical manifestations and testing indicators between the elderly HBV-GN and HBV-CG patients, HBV-GN patients are still significantly different from HBV-CG patients in terms of serum virology and pathological changes.Therefore, we should pay attention to the serum HBV replication and renal pathological changes to provide a clinical basis for treating this kind of elderly patients.