Year 2020 / Volume 112 / Number 11
Original
Efficacy of entecavir in treating hepatitis B virus-associated membranous nephropathy

843-849

DOI: 10.17235/reed.2020.6762/2019

Lifen Wang, Bingying Xie, Quan Zheng, Lixia Xu, Zhiming Ye,

Abstract
Objective: hepatitis B virus-associated membranous nephropathy (HBV-MN) is the most common pathological type of hepatitis B virus-associated glomerulonephritis. This study evaluated the efficacy of entecavir antiviral therapy for HBV-MN patients due to the intolerable side effects of interferon-alpha and high incidence rate of drug-resistance in lamivudine therapy. Method: thirty-two patients with HBV-MN were identified by biopsy and treated with entecavir for 52 weeks. These patients were followed up to evaluate outcomes of entecavir-treatment. Descriptive statistics were used to summarize patient demographics and treatment outcomes. Results: entecavir treatment reduced 24-h urinary protein excretion. The total probability of partial proteinuria and complete remission at 24 and 52 weeks was 53.1 and 78.1 %, respectively. A decrease of circulating HBV-DNA was observed in all patients with active HBV replication. The significant decrease of 24-h urinary protein began at 12 weeks, as early as the decrease of serum HBV-DNA level. The serum HBV DNA titers at baseline and after 52 weeks of treatment were 4.3 ± 2.8 log10 and 2.3 ± 1.7 log10, respectively. Meanwhile, eGFR increased from 100.3 ± 20.5 ml/min/1.73 m2 at baseline to 107.7 ± 15.9 ml/min/1.73 m2 after 52 weeks of treatment. The serum alanine aminotransferase level (ALT) gradually decreased to normal during entecavir antiviral treatment. Conclusions: entecavir treatment in HBV-MN patients was carefully described. Complete remission and HBV replication suppression were induced by entecavir treatment in HBV-MN patients. Patients with high serum creatinine (Scr), ALT and low eGFR levels benefit more from entecavir treatment. Entecavir therapy is well tolerated by patients and no adverse reactions were observed.
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References
1. AS S, DN A. Spectrum of hepatitis B and renal involvement. Liver international : official journal of the International Association for the Study of the Liver. 2018;38:23-32.
2. KN L, PK L, SF L, et al. Membranous nephropathy related to hepatitis B virus in adults. The New England journal of medicine. 1991;324:1457-1463.
3. HS C, JH H, HA A, et al. Long-term outcome of hepatitis B virus-related glomerulonephritis after therapy with interferon alfa. Gastroenterology. 1995;109:540-546.
4. SO O, S G, K T. Hepatitis-B virus associated nephropathies: a clinicopathological study in 14 children. Pediatric nephrology (Berlin, Germany). 2003;18:23-28.
5. Liu T, Yang S, Yue Z, et al. Clinical and pathological characteristics of 5 children with HBV surface antigen (HBsAg)-negative hepatitis B virus-associated glomerulonephritis. J Clin Virol. 2015;66:1-5.
6. Sun LJ, Shan JP, Cui RL, et al. 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. Int Urol Nephrol. 2017;49:1049-1056.
7. Yan Z, Qiao B, Zhang H, et al. Effectiveness of telbivudine antiviral treatment in patients with hepatitis B virus-associated glomerulonephritis: A 104-week pilot study. Medicine. 2018;97:e11716.
8. Yang Y, Ma YP, Chen DP, et al. A Meta-Analysis of Antiviral Therapy for Hepatitis B Virus-Associated Membranous Nephropathy. PLoS One. 2016;11:e0160437.
9. Chung DR, Yang WS, Kim SB, et al. Treatment of hepatitis B virus associated glomerulonephritis with recombinant human alpha interferon. Am J Nephrol. 1997;17:112-117.
10. IO S, YA H, HS P, et al. Experience of anti-viral therapy in hepatitis B-associated membranous nephropathy, including Lamivudine-resistant strains. The Korean journal of internal medicine. 2012;27:411-416.
11. YF Y, QF X, W Z, YD Z. Complete remission of hepatitis B virus-related membranous nephropathy after entecavir monotherapy. Clinics and research in hepatology and gastroenterology. 2012;36:e89-92.
12. Kataoka H, Mochizuki T, Akihisa T, et al. Successful entecavir plus prednisolone treatment for hepatitis B virus-associated membranoproliferative glomerulonephritis: A case report. Medicine. 2019;98:e14014.
13. Xiong QF, Zhong YD, Hu ZL, Yang YF. Successful treatment of occult hepatitis B virus infection related membranous nephropathy after entecavir therapy. Acta Clin Belg. 2015;70:223-225.
14. Wang L, Ye Z, Liang H, et al. The combination of tacrolimus and entecavir improves the remission of HBV-associated glomerulonephritis without enhancing viral replication. Am J Transl Res. 2016;8:1593-1600.
15. Watashi K, Sluder A, Daito T, et al. Cyclosporin A and its analogs inhibit hepatitis B virus entry into cultured hepatocytes through targeting a membrane transporter, sodium taurocholate cotransporting polypeptide (NTCP). Hepatology. 2014;59:1726-1737.
16. Yan H, Zhong G, Xu G, et al. Sodium taurocholate cotransporting polypeptide is a functional receptor for human hepatitis B and D virus. eLife. 2012;1:e00049.
17. S T, FM L, YH L, et al. Lamivudine in hepatitis B-associated membranous nephropathy. Kidney international. 2005;68:1750-1758.
18. Ng YY, Yang WC, Lee ST. Long-term lamivudine therapy in hepatitis B-associated membranous nephropathy? Kidney Int. 2006;69:776.DOI: 10.1038/sj.ki.5000171
19. Li H, Yuan X, Qiu L, et al. Efficacy of adefovir dipivoxil combined with a corticosteroid in 38 cases of nephrotic syndrome induced by hepatitis B virus-associated glomerulonephritis. Renal failure. 2014;36:1404-1406.
20. F F, V D, P M. Meta-analysis: anti-viral therapy of hepatitis B virus-associated glomerulonephritis. Alimentary pharmacology & therapeutics. 2006;24:781-788.
21. Yuen MF, Lai CL. Treatment of chronic hepatitis B: Evolution over two decades. J Gastroenterol Hepatol. 2011;26 Suppl 1:138-143.
22. Chang TT, Gish RG, de Man R, et al. A comparison of entecavir and lamivudine for HBeAg-positive chronic hepatitis B. N Engl J Med. 2006;354:1001-1010.
23. DJ T, RE R, CJ B, et al. Long-term monitoring shows hepatitis B virus resistance to entecavir in nucleoside-naïve patients is rare through 5 years of therapy. Hepatology (Baltimore, Md.). 2009;49:1503-1514.DOI: 10.1002/hep.22841
24. KN L, RT H, JS T, FM L. Detection of hepatitis B virus DNA and RNA in kidneys of HBV related glomerulonephritis. Kidney international. 1996;50:1965-1977.
25. L C, C W, X F, et al. Replication and infectivity of hepatitis B virus in HBV-related glomerulonephritis. International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases. 2009;13:394-398.
26. Lai KN, Lai FM, Tam JS. IgA nephropathy associated with chronic hepatitis B virus infection in adults: the pathogenetic role of HBsAG. J Pathol. 1989;157:321-327.
27. Lai KN, Li PK, Lui SF, et al. Membranous nephropathy related to hepatitis B virus in adults. The New England journal of medicine. 1991;324:1457-1463.
1. Shah AS, Amarapurkar DN. Spectrum of hepatitis B and renal involvement. Liver Int 2018;38(1):23-32.
2. Lai KN, Li PK, Lui SF, et al. Membranous nephropathy related to hepatitis B virus in adults. N Engl J Med 1991;324(21):1457-63.
3. Conjeevaram HS1, Hoofnagle JH, Austin HA, et al. Long-term outcome of hepatitis B virus-related glomerulonephritis after therapy with interferon alfa. Gastroenterology 1995;109(2):540-6.
4. Ozdamar SO, Gucer S, Tinaztepe K. Hepatitis-B virus associated nephropathies: a clinicopathological study in 14 children. Pediatr Nephrol 2003;18(1):23-8.
5. Liu T, Yang S, Yue Z, et al. Clinical and pathological characteristics of 5 children with HBV surface antigen (HBsAg)-negative hepatitis B virus-associated glomerulonephritis. J Clin Virol 2015 May;66:1-5.
6. Sun LJ, Shan JP, Cui RL, et al. 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. Int Urol Nephrol 2017 Jun;49(6):1049-56.
7. Yan Z, Qiao B, Zhang H, et al. Effectiveness of telbivudine antiviral treatment in patients with hepatitis B virus-associated glomerulonephritis: A 104-week pilot study. Medicine 2018 Aug;97(31):e11716.
8. Yang Y, Ma YP, Chen DP, et al. A Meta-Analysis of Antiviral Therapy for Hepatitis B Virus-Associated Membranous Nephropathy. PLoS One. 2016;11(9):e0160437.
9. Chung DR, Yang WS, Kim SB, et al. Treatment of hepatitis B virus associated glomerulonephritis with recombinant human alpha interferon. Am J Nephrol. 1997;17(2):112-7.
10. Sun IO, Hong YA, Park HS, et al. Experience of anti-viral therapy in hepatitis B-associated membranous nephropathy, including Lamivudine-resistant strains. Korean J Intern Med 2012;27(4):411-6.
11. Yang YF, Xiong QF, Zhao W, et al. Complete remission of hepatitis B virus-related membranous nephropathy after entecavir monotherapy. Clin Res Hepatol Gastroenterol 2012;36(5):e89-92.
12. Kataoka H, Mochizuki T, Akihisa T, et al. Successful entecavir plus prednisolone treatment for hepatitis B virus-associated membranoproliferative glomerulonephritis: A case report. Medicine. 2019 Jan;98(2):e14014.
13. Xiong QF, Zhong YD, Hu ZL, et al. Successful treatment of occult hepatitis B virus infection related membranous nephropathy after entecavir therapy. Acta Clin Belg. 2015 Jun;70(3):223-5.
14. Wang L, Ye Z, Liang H, et al. The combination of tacrolimus and entecavir improves the remission of HBV-associated glomerulonephritis without enhancing viral replication. Am J Transl Res. 2016;8(3):1593-600.
15. Watashi K, Sluder A, Daito T, et al. Cyclosporin A and its analogs inhibit hepatitis B virus entry into cultured hepatocytes through targeting a membrane transporter, sodium taurocholate cotransporting polypeptide (NTCP). Hepatology 2014 May;59(5):1726-37.
16. Yan H, Zhong G, Xu G, et al. Sodium taurocholate cotransporting polypeptide is a functional receptor for human hepatitis B and D virus. eLife. 2012;1:e00049.
17. Tang S, Lai FM, Lui YH, et al. Lamivudine in hepatitis B-associated membranous nephropathy. Kidney Int 2005;68(4):1750-8.
18. Ng YY, Yang WC, Lee ST. Long-term lamivudine therapy in hepatitis B-associated membranous nephropathy? Kidney Int. 2006 Feb;69(4):776.
19. Li H, Yuan X, Qiu L, et al. Efficacy of adefovir dipivoxil combined with a corticosteroid in 38 cases of nephrotic syndrome induced by hepatitis B virus-associated glomerulonephritis. Ren Fail 2014 Oct;36(9):1404-6.
20. Fabrizi F, Dixit V, Martin P. Meta-analysis: anti-viral therapy of hepatitis B virus-associated glomerulonephritis. Aliment Pharmacol Ther 2006;24(5):781-8.
21. Yuen MF, Lai CL. Treatment of chronic hepatitis B: Evolution over two decades. J Gastroenterol Hepatol. 2011 Jan;26 Suppl 1:138-43.
22. Chang TT, Gish RG, de Man R, et al. A comparison of entecavir and lamivudine for HBeAg-positive chronic hepatitis B. N Engl J Med. 2006 Mar 9;354(10):1001-10.
23. Tenney DJ, Rose RE, Baldick CJ, et al. Long-term monitoring shows hepatitis B virus resistance to entecavir in nucleoside-naïve patients is rare through 5 years of therapy. Hepatology 2009;49(5):1503-14.
24. Lai KN1, Ho RT, Tam JS, et al. Detection of hepatitis B virus DNA and RNA in kidneys of HBV related glomerulonephritis. Kidney Int 1996;50(6):1965-77.
25. Chen L, Wu C, Fan X, et al. Replication and infectivity of hepatitis B virus in HBV-related glomerulonephritis. Int J Infect Dis 2009;13(3):394-8.
26. Lai KN, Lai FM, Tam JS. IgA nephropathy associated with chronic hepatitis B virus infection in adults: the pathogenetic role of HBsAG. J Pathol 1989 Apr;157(4):321-7.
27. Lai KN, Li PK, Lui SF, et al. Membranous nephropathy related to hepatitis B virus in adults. N Engl J Med 1991 May 23;324(21):1457-63.
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Wang L, Xie B, Zheng Q, Xu L, Ye Z. Efficacy of entecavir in treating hepatitis B virus-associated membranous nephropathy. 6762/2019


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Publication history

Received: 21/11/2019

Accepted: 23/02/2020

Online First: 15/10/2020

Published: 10/11/2020

Article revision time: 86 days

Article Online First time: 329 days

Article editing time: 355 days


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