Year 2020 / Volume 112 / Number 11
Original
Efficacy of entecavir in treating hepatitis B virus-associated membranous nephropathy

843-849

DOI: 10.17235/reed.2020.6762/2019

Lifen Wang, Bingying Xie, Quan Zheng, Lixia Xu, Zhiming Ye,

Abstract
Objective: hepatitis B virus-associated membranous nephropathy (HBV-MN) is the most common pathological type of hepatitis B virus-associated glomerulonephritis. This study evaluated the efficacy of entecavir antiviral therapy for HBV-MN patients due to the intolerable side effects of interferon-alpha and high incidence rate of drug-resistance in lamivudine therapy. Method: thirty-two patients with HBV-MN were identified by biopsy and treated with entecavir for 52 weeks. These patients were followed up to evaluate outcomes of entecavir-treatment. Descriptive statistics were used to summarize patient demographics and treatment outcomes. Results: entecavir treatment reduced 24-h urinary protein excretion. The total probability of partial proteinuria and complete remission at 24 and 52 weeks was 53.1 and 78.1 %, respectively. A decrease of circulating HBV-DNA was observed in all patients with active HBV replication. The significant decrease of 24-h urinary protein began at 12 weeks, as early as the decrease of serum HBV-DNA level. The serum HBV DNA titers at baseline and after 52 weeks of treatment were 4.3 ± 2.8 log10 and 2.3 ± 1.7 log10, respectively. Meanwhile, eGFR increased from 100.3 ± 20.5 ml/min/1.73 m2 at baseline to 107.7 ± 15.9 ml/min/1.73 m2 after 52 weeks of treatment. The serum alanine aminotransferase level (ALT) gradually decreased to normal during entecavir antiviral treatment. Conclusions: entecavir treatment in HBV-MN patients was carefully described. Complete remission and HBV replication suppression were induced by entecavir treatment in HBV-MN patients. Patients with high serum creatinine (Scr), ALT and low eGFR levels benefit more from entecavir treatment. Entecavir therapy is well tolerated by patients and no adverse reactions were observed.
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12. Kataoka H, Mochizuki T, Akihisa T, et al. Successful entecavir plus prednisolone treatment for hepatitis B virus-associated membranoproliferative glomerulonephritis: A case report. Medicine. 2019 Jan;98(2):e14014.
13. Xiong QF, Zhong YD, Hu ZL, et al. Successful treatment of occult hepatitis B virus infection related membranous nephropathy after entecavir therapy. Acta Clin Belg. 2015 Jun;70(3):223-5.
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Wang L, Xie B, Zheng Q, Xu L, Ye Z. Efficacy of entecavir in treating hepatitis B virus-associated membranous nephropathy. 6762/2019


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Publication history

Received: 21/11/2019

Accepted: 23/02/2020

Online First: 15/10/2020

Published: 10/11/2020

Article revision time: 86 days

Article Online First time: 329 days

Article editing time: 355 days


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