Yang Yue, Ma Ye-Ping, Chen Da-Peng, Zhuo Li, Li Wen-Ge
Department of nephrology, China-Japan friendship hospital, Beijing, PR China.
PLoS One. 2016 Sep 6;11(9):e0160437. doi: 10.1371/journal.pone.0160437. eCollection 2016.
Hepatitis B virus-associated membranous nephropathy (HBV-MN) is the most common renal extra-hepatic manifestation in patients with chronic HBV infection. In September 2015, we searched the MEDLINE, EMBASE, and CENTRAL databases, and the reference lists of retrieved articles, to identify relevant studies. Descriptions of antiviral drugs used to treat HBV-MN were included in our review. Two authors independently screened all relevant articles, extracted data, and assessed the risk of bias. Nine hundred and fifty-four papers have been considered after electronic and manual searching, only five relevant studies were identified. Complete remission (OR = 26.87, 95% CI: 8.06 to 89.52), total remission (OR = 10.31, 95% CI: 3.59 to 29.63) of proteinuria and HBeAg clearance (OR = 20.91, 95% CI: 6.90 to 63.39) increased significantly after antiviral therapy. No significant differences were seen between interferon and nucleoside analog treatments. Our study found that antiviral therapy was an effective treatment in HBV-MN patients; interferon and nucleoside analogs were equally effective at causing proteinuria remission and HBeAg clearance.
乙型肝炎病毒相关性膜性肾病(HBV-MN)是慢性HBV感染患者中最常见的肾脏肝外表现。2015年9月,我们检索了MEDLINE、EMBASE和CENTRAL数据库以及检索文章的参考文献列表,以识别相关研究。我们的综述纳入了用于治疗HBV-MN的抗病毒药物的描述。两位作者独立筛选所有相关文章、提取数据并评估偏倚风险。经过电子和人工检索后共考虑了954篇论文,仅识别出5项相关研究。抗病毒治疗后蛋白尿的完全缓解(OR = 26.87,95% CI:8.06至89.52)、总缓解(OR = 10.31,95% CI:3.59至29.63)以及HBeAg清除(OR = 20.91,95% CI:6.90至63.39)均显著增加。干扰素和核苷类似物治疗之间未见显著差异。我们的研究发现抗病毒治疗是HBV-MN患者的有效治疗方法;干扰素和核苷类似物在导致蛋白尿缓解和HBeAg清除方面同样有效。