A number of reports are now present in which glomerulonephritis is associated with hepatitis B virus (HBV) infection. In persons who carry HBV, HBV antigens and antibodies wax and wane in the blood and form antigen-antibody complex, detectable in the cryoprecipitate or polyethylene glycol precipitate. The antigens and/or antibodies were detectable in the glomerular basement membrane by immunofluorescent studies and were extractable from the basement membrane. It is therefore increasingly evident that HBV infection can cause immune complex mediated glomerulonephritis. HBV infection is now prevalent in Korea with 7 to 8°%% positive rate of HBsAg in healthy adults. The purpose of this study is to show the role of HBV antigens in the formation of glomerulonephritis.
Patients with significant proteinuria and/ or increased levels of SGPT were randon. selected and from clinical assessment and biopsies the patients were divided into four groups:
116 . cases of patients with glomerulopathy,
115 cases of patients with hepatic diseases,
127 cases with other diseases, and
77 healthy normal control.
Sera were separated, stored in - 20 degree C. and sent frozen in dry-ice to the Institute for Cancer Reserch, Philadelphia, U.S.A. and were measured for HBsAg, anti-HBs, and anti-HBc.
Results:
1) In healthy normal control group, the HBsAg was positive in 12% of males, 6.7% of females, and 7.8% of both sexes. Anti-HBs was positive in 65% of the male: and 68 % of the female group. Anti-HBc was positive in 7601o of the male and 78 of the female group.
2) As a whole study group, HBsAg positive rate tended to decline as age increased. The positive rates of anti-HBs and anti-HBc were conversely increased.
3) ´The positive rates of the three HBV markers were statistically not significantbetween the renal and healthy groups, or between the renal and other disease group.
4) Renal biopsies were performed in. 24 patients, and minimal change glomerulop-athies were excluded from the study. Of 12 patients with glomerulonephritis, 3casesor 25 % were positive for HBsAg. More statistically significant differenences might have been obtained if there were more biopsy samples or if pediatric ages were included.
5) Of renal disease group, positive rate of antiHBs was significantly higher in patients with chronic renal failure than those without (77. 8 % vs 48. 5I ). Uninfected rate was lower in patients with renal failure than those without (4.4% vs 39.4%x).
6) Urinary specific gravity was significantly lower in HBsAg positive group (1. 015) than the uninfected group(1.020, p less than 0. 005). It is specluated that ::HBV alter the renal concentrating function.
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