The Journal of Medical Microbiology, Vol 29, Issue 4 243-249, Copyright © 1989 by Society for General Microbiology
Serum and tissue positivity for hepatitis B virus markers in histopathologically proven glomerulonephropathies
S. P. Thyagarajan, T. Thirunalasundari, S. Subramanian, M. Panchanadam, B. R. Nammalwar, V. Prabha, and M. Jayaraman
Department of Microbiology, University of Madras, Taramani, India.
To assess the pathogenic significance of hepatitis B virus (HBV) in
glomerulonephritis (GN), 98 patients with histopathologically proven
glomerulonephropathies were screened for HBV markers, complement components
and levels of circulating immune complexes (CICs); and renal biopsies from
31 of them were examined for the presence of hepatitis B surface antigen
(HBsAg), and its location, by immunoperoxidase staining. The HBsAg positive
rate in the patients (who came from a population with 10% HBsAg positivity)
ranged from 51.9% in minimum change nephrotic syndrome (MCNS) to 81.8% in
patients with proliferative glomerulonephritis (PGN). Whereas 24.5% of the
cases were positive for HBsAg only, 10.2% had anti-HBcIgM with HBsAg, 13.3%
had HBeAg with HBsAg and 9.2% had HBsAg, HBeAg and anti-HBcIgM. Complement
component C3 levels were decreased in all groups of GN studied, but C4
levels varied. CIC levels were significantly increased (p less than 0.01)
only in HBsAg-positive MCNS, focal glomerulosclerosis (FGS) and membranous
glomerulonephritis (MGN). Of the 31 renal biopsies examined for the
deposition of HBsAg, 4 (12.9%) were found to be positive for HBsAg in situ;
64.5% of biopsied patients were seropositive for HBsAg and 77.4% had CICs.
All the four in-situ HBsAg-positive cases were seropositive for HBsAg,
HBeAg and anti-HBcIgM with significantly high CIC levels (p less than
0.01). HBsAg deposition was intracytoplasmic in the mesangial cells of the
glomeruli, in the glomerular basement membrane or in the tubules, or in a
combination of these sites.
