Clinical Study Of Hepatitis B Virus-associated Glomerulonephritis Treated By Lamivudine

【Objective】Observe the effect of lamivudine treatment for hepatitis B virus-associatedglomerulonephritis(HBV-GN),to find an effective treatment program to guide thefuture clinical treatment; examined the Hepatitis B virus (HBV) genotypes inHBV-GN，observe the correlation between HBV genotypes and HBV-GN，the effectof lamivudine treatment in HBV-GN of different HBV genotypes and drug resistantmutations the lamivudine treatment in HBV-GN.【Methods】This study collected20patients with HBV-GN that were diagnosed with biopsyproven HBV-associated GN, those who treated with lamivudine therapy48weeks inour division of nephrology from2012-2013. All patients were observed for48weekson liver and kidney function(ALT, ALB, Scr and urinary protein of24hours),thequality of HBV-DNA and remission rate;Take limosis blood from the patients whenthey receive the treat in the first time, HBV genotypes were detected by Gene ChipAssay, HBV serum maker were detected by ELISA, the quality of HBV-DNA weredetected by Gene Chip Assay, the drug resistant mutations for the patients who justhave partial remission or inefficiency after the treatment of48weeks was made byGene Chip Assay.【Results】1、After48week of treatment,9cases of20cases of HBV-GN patients whichwere complete remission,4cases were significantly relieved,4cases were partialremission and3cases were ineffective, the total effective rate was85%and thesignificantly effective rate was65%. 2、There was no significant difference when the results about Scr of20HBV-GN after48weeks treatment compared with before treatment(P＜0.05);butthere were significant differences when the results about daily excretion、ALT、ALBand the quality of HBV-DNA of20HBV-GN after48weeks treatment compared withbefore LAM treatment (P＜0.05).3、HBV genotypes: genotype B6case (30%), genotype C case (50%)，genotype B/C4case (20%)。4、 There was no significant difference when ALT、ALB、Scr、urinary proteinof24hours and the quality of HBV-DNA in genotype C compared with genotype B(P＞0.05).5、The level of decline of the quality of HBV-DNA in genotype B wassignificant higher than genotype C after36weeks treatment (P＜0.05).6、The7patients who just had partial remission or ineffective after48weekstreatment all had LAM resistance and1patients also had ADV resistance.【Conclusions】1、Lamivudine treatment for HBV-GN is an effective clinical method.2、There was no significant difference when ALT、ALB、Scr、urinary proteinof24hours and the quality of HBV-DNA in genotype C patients compare withgenotype B before the LAM treatment.3、The effect of LAM treatment in genotype B patients is more well thangenotype C.4、There was drug resistance because of the long time using of LAM.