DETECTION OF HBsAg IN RENAL TISSUE OF PATIENTS WITH GLOMERULONEPHRITIS

Dr. G. M. Hafizur Rahman*, Professor (Dr.) Muhammad Rafiqul Alam, Dr. Hossain Muhammad Mustafijur Rahman, Dr. Al Asma Ul Taslima, Dr. Tanvir Rahman, Dr. Faruque Ahmed, Dr. Nahid Afrin, Dr. Md Dilder Hossain Badal and Dr. Golam Mahbub Sikder

ABSTRACT

Introduction: Hepatitis B virus infection is a severe public health problem worldwide and it causes not only hepatic diseases but also extra hepatic manifestations particularly HBV-associated Glomerulonephritis (GN). HBsAg has been observed in the glomeruli of some patients with glomerulonephritis. HBV related glomerulonephritis may be found in HBV seropositive as well as seronegative patients. HBV may present in the renal tissue of such patients. In most cases detection of HBsAg in the renal tissue by renal biopsy and immunohistochemistry can establish the etiology. Objective: To estimate the frequency of HBsAg deposition in renal tissue of patients with glomerulonephritis. Method: This cross sectional study was done in the Department of Nephrology, BSMMU, during the period of July 2015 to June 2016. A total number of 53 cases who fulfilled the inclusion and exclusion criteria were selected as sample. Samples were selected by purposive sampling technique. Results: HBsAg antigen in renal tissue was found in 2 patients among 7 patients who were seropositive for both HBsAg and Anti HBc(total), 2 patients among 8 patients who were HBsAg seronegative but Anti HBc (total) seropositive , 2 patients among 38 patients who were seronegative for both HBsAg and Anti HBc(total). There were no patients in this study who was HBsAg seropositive but Anti HBc (total) seronegative. Total 11.3% (6 patients) of renal biopsy specimens were found to have HBsAg deposits which included 3 cases of Membranoproliferative GN and one of each of Membranous nephropathy, Mesangial proliferative GN and IgA nephropathy. Conclusion: The high rate of HBsAg deposits found in renal tissue indicates that detection of HBsAg deposition should be done for all histological varieties of GN. So that antiviral therapy can be used to stop progression of HBV associated nephropathy.

Keywords: HBsAg, Anti HBc (total), Renal Biopsy, Glomerulonephritis.