Is there a hepatitis B virus-associated glomerulonephritis? Identification of HBsAG, HBcAG and HBeAG in kidney with monoclonal antibodies.

In an attempt to clarify the relationship between hepatitis B virus (HBV) infection and glomerulonephritis (GN), and to explore the significance and possible mechanisms of HBV deposition in kidney, renal biopsy specimens obtained from 69 HBV carriers with various forms of GN and 69 age-, sex-, and renal histology-matched controls were studied with 4-layer PAP immunoperoxidase and indirect immunofluorescence techniques using monoclonal antibodies to HBV surface (HBsAg), core (HBcAg) and e antigen (HBeAg). The 3 HBV associated antigens were detected in the kidney in 18/18 patients with membranous nephropathy and in 21/26 (80.8%) patients with lupus nephritis regardless of whether HBV antigenemia was present or not. In certain types of primary GN, including IgA nephropathy, mesangial proliferative GN and membrano-proliferative GN, HBsAg in the kidney was more common in patients with HBs antigenemia than in those without it (49.1% vs 26.4%, P less than 0.05). No significant difference was observed between patients with and without HBV antigenemia in terms of HBcAg or HBeAg deposition in kidney. Immunopathological studies showed granular deposition of HBV antigens in exactly the same pattern as that of Ig(s) and complement components, and the characteristics of HBV deposition in the kidney were closely correlated with the extent of immune deposits. We conclude that the deposition of HBV-associated antigens in the kidney is often non-specific, although HBsAg is more commonly seen in some HBsAg carriers with GN.(ABSTRACT TRUNCATED AT 250 WORDS)