Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China.
World J Gastroenterol. 2010 Feb 14;16(6):770-7. doi: 10.3748/wjg.v16.i6.770.
To evaluate the efficacy of antiviral or corticosteroid treatment on hepatitis B virus-associated glomerulonephritis (HBV-GN).
Six and five trials were used respectively to evaluate the efficacy of either antiviral or corticosteroid treatment on HBV-GN. Pediatric patients were pooled separately to assess their response to the above treatment modalities. The primary and secondary outcomes were remission of proteinuria and clearance of Hepatitis B e-antigen (HBeAg), respectively. A fixed or random effect model was established to collect the data.
The remission rate of proteinuria (RR = 1.69, 95% CI: 1.08-2.65) and the clearance rate of HBeAg (RR = 6.44, 95% CI: 3.11-13.35) were significantly higher in antiviral treatment group than in control group. The proteinuria remission was significantly associated with HBeAg clearance (P = 0.002). However, the difference in proteinuria remission rate was not statistically significant between corticosteroid treatment group and control group (RR = 1.45, 95% CI: 0.68-3.11). Antiviral therapy could significantly promote the HBeAg clearance in pediatric patients, but neither antiviral nor corticosteroid therapy could significantly decrease proteinuria in pediatric patients compared to controls.
Antiviral but not corticosteroid treatment can decrease proteinuria and promote HBeAg clearance in HBV-GN patients.
评估抗病毒或皮质类固醇治疗乙型肝炎病毒相关性肾小球肾炎（HBV-GN）的疗效。
分别使用 6 项和 5 项试验评估抗病毒或皮质类固醇治疗对 HBV-GN 的疗效。分别对儿科患者进行汇总，以评估他们对上述治疗方法的反应。主要和次要结局分别为蛋白尿缓解和乙型肝炎 e 抗原（HBeAg）清除。建立固定或随机效应模型来收集数据。
抗病毒治疗组蛋白尿缓解率（RR=1.69，95%CI：1.08-2.65）和 HBeAg 清除率（RR=6.44，95%CI：3.11-13.35）均明显高于对照组。HBeAg 清除与蛋白尿缓解显著相关（P=0.002）。然而，皮质类固醇治疗组与对照组之间蛋白尿缓解率的差异无统计学意义（RR=1.45，95%CI：0.68-3.11）。抗病毒治疗可显著促进儿童患者 HBeAg 清除，但与对照组相比，抗病毒或皮质类固醇治疗均不能显著降低儿童患者的蛋白尿。
抗病毒治疗而非皮质类固醇治疗可降低 HBV-GN 患者的蛋白尿并促进 HBeAg 清除。
