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HBV 抗原在肾脏中的沉积与 HBV 感染 IgA 肾病患者肾脏预后的关系。

The relationship between HBV antigens deposition in kidneys and renal prognosis in IgA nephropathy patients infected with HBV.

机构信息

Guangdong Provincial Key Laboratory of Autophagy and Major Chronic Non-Communicable Diseases, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China.

Department of Nephrology, Hainan General Hospital, Haikou, China.

出版信息

Ren Fail. 2024 Dec;46(2):2417737. doi: 10.1080/0886022X.2024.2417737. Epub 2024 Nov 18.

DOI:10.1080/0886022X.2024.2417737
PMID:39555693
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11574957/
Abstract

BACKGROUND

Hepatitis B virus (HBV) is a risk factor for the progression of immunoglobulin A (IgA) nephropathy. The effect of HBV antigens deposition in kidneys and treatment influencing HBV deposition requires further investigation.

METHODS

We analyzed 198 patients with IgAN, including 99 patients with HBV infection and 99 propensity score-matched patients without HBV infection. The primary outcome was a composite of 30% decrease in eGFR from the baseline, kidney failure and all-cause mortality. A Cox proportional hazard model was used to assess the impact of both HBV positive in the serum and HBV antigens deposition in the kidneys on renal outcomes.

RESULTS

Among 198 individuals, 27 primary composite outcome events were observed, of which 20 (20%) in the HBV positive group and seven (7%) were in the HBV-negative group. The former had a 2.72-fold increased risk of primary outcome events (adjusted hazard ratio: 2.22; 95% confidence interval: 0.89-5.53). HBV antigens deposition in kidneys increased the risk significantly after adjusting for confounders at the latest follow-up (adjusted hazard ratio: 7.49; 95% confidence interval: 1.00-56.04). Antiviral treatment did not influence the deposition of HBV antigens.

CONCLUSIONS

HBV antigen deposition in the kidneys, compared with no deposition in the kidneys, was associated with a 7.49-fold increased risk of renal prognosis in patients with IgA nephropathy.

摘要

背景

乙型肝炎病毒（HBV）是 IgA 肾病进展的一个危险因素。HBV 抗原在肾脏中的沉积以及治疗对 HBV 沉积的影响需要进一步研究。

方法

我们分析了 198 例 IgA 肾病患者，其中 99 例有 HBV 感染，99 例匹配的无 HBV 感染患者。主要结局是 eGFR 从基线下降 30%、肾衰竭和全因死亡率的综合指标。采用 Cox 比例风险模型评估血清 HBV 阳性和 HBV 抗原在肾脏中的沉积对肾脏结局的影响。

结果

在 198 名个体中，观察到 27 例主要复合结局事件，其中 HBV 阳性组 20 例（20%），HBV 阴性组 7 例（7%）。前者发生主要结局事件的风险增加了 2.72 倍（调整后的危险比：2.22；95%置信区间：0.89-5.53）。在最新随访时，调整混杂因素后，HBV 抗原在肾脏中的沉积显著增加了风险（调整后的危险比：7.49；95%置信区间：1.00-56.04）。抗病毒治疗并未影响 HBV 抗原的沉积。

结论

与肾脏无 HBV 抗原沉积相比，IgA 肾病患者肾脏中 HBV 抗原沉积与肾脏预后风险增加 7.49 倍相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b23/11574957/b63fc77d0c0a/IRNF_A_2417737_F0007_C.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b23/11574957/b1aa702d9820/IRNF_A_2417737_F0001_B.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b23/11574957/86e6fe6a34d7/IRNF_A_2417737_F0002_C.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b23/11574957/fbb93f6047ec/IRNF_A_2417737_F0003_B.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b23/11574957/f9b789acf6ba/IRNF_A_2417737_F0004_B.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b23/11574957/0eecf2298828/IRNF_A_2417737_F0005_C.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b23/11574957/be521ae7b877/IRNF_A_2417737_F0006_B.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b23/11574957/b63fc77d0c0a/IRNF_A_2417737_F0007_C.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b23/11574957/b1aa702d9820/IRNF_A_2417737_F0001_B.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b23/11574957/86e6fe6a34d7/IRNF_A_2417737_F0002_C.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b23/11574957/fbb93f6047ec/IRNF_A_2417737_F0003_B.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b23/11574957/f9b789acf6ba/IRNF_A_2417737_F0004_B.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b23/11574957/0eecf2298828/IRNF_A_2417737_F0005_C.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b23/11574957/be521ae7b877/IRNF_A_2417737_F0006_B.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b23/11574957/b63fc77d0c0a/IRNF_A_2417737_F0007_C.jpg

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