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Hepatitis B reactivation in HBsAg-negative/HBcAb-positive patients receiving immunosuppressive therapy for glomerulonephritis: a retrospective analysis

  • Nephrology - Original Paper
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Abstract

Purpose

The aim of this study is to investigate the prevalence and risk factors for hepatitis B virus (HBV) reactivation in HBsAg-negative/HBcAb-positive patients receiving immunosuppressive therapy for glomerulonephritis.

Methods

We performed a retrospective study of 745 HBsAg-negative/HBcAb-positive patients undergoing immunosuppressive therapy for glomerulonephritis from years 2003 to 2012 at the department of nephrology, China-Japan Friendship Hospital, Beijing, China. The patients were divided into HBV reactivation group (n = 27) and non-HBV reactivation group (n = 718).

Results

The prevalence of HBV reactivation in patients receiving immunosuppressive therapy for glomerulonephritis was up to 3.62% in serological status of HBsAg-negative/HBcAb-positive. HBV reactivation was associated with several findings: greater proportion of lupus nephritis (25.93 vs. 9.61%, p = 0.014), much higher percentage of HBsAb-negative (74.07 vs. 23.82%, p < 0.001), longer duration of immunosuppressive treatment (100 vs. 70.06%, p < 0.001), as well as more cases of combined immunosuppressant (92.59 vs. 61.56%, p = 0.001). After univariate and multivariate analysis, three variables remained as independent risk factors for HBV reactivation: serological status of HBsAb-negative (OR 8.375, 95% CI 3.674–19.776, p = 0.001), length of immunosuppressive treatment more than 1 year (OR 1.308, 95% CI 1.121–1.358, p = 0.024), and combined immunosuppressant (OR 6.342, 95% CI 1.675–30.166, p = 0.003).

Conclusions

HBV reactivation is not uncommon in HBsAg-negative/HBcAb-positive glomerulonephritis patients treated with immunosuppressant, and the prevalence was up to 3.62%. Patients with serological status of HBsAb-negative, more than 1 year of immunosuppressive therapy, and combined immunosuppressant are independent risk factors for HBV reactivation.

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Acknowledgements

The authors thank the many physicians who cared for the patients described in this report, including Drs. Yun Jiang, Wen Chen, Yanfang Yang, Duo Li, Li Zhuo, Yali Cao, and the nursing staff of nephrology department.

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Authors and Affiliations

  1. Department of Nephrology, China-Japan Friendship Hospital, No. 2 East Yinghua Street, Chaoyang District, Beijing, 100029, China

    Jing Fang, Wenge Li, Zhao Tan, Min Tan, Cong Zhang, Wenbo Wang, Zhihong Xu & Gumin Zhou

  2. Department of Hepatology, China-Japan Friendship Hospital, Beijing, China

    Xiangxin Peng

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  1. Jing Fang
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  2. Wenge Li
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  3. Xiangxin Peng
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  4. Zhao Tan
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  5. Min Tan
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Correspondence to Jing Fang.

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Fang, J., Li, W., Peng, X. et al. Hepatitis B reactivation in HBsAg-negative/HBcAb-positive patients receiving immunosuppressive therapy for glomerulonephritis: a retrospective analysis. Int Urol Nephrol 49, 475–482 (2017). https://doi.org/10.1007/s11255-016-1487-5

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