LONG-TERM OUTCOME OF HEPATITIS-B VIRUS-RELATED GLOMERULONEPHRITIS AFTER THERAPY WITH INTERFERON-ALFA

Background and Aims: Glomerulonephritis is an uncommon complication of chronic hepatitis B virus (HBV) infection in adults. A high percentage of patients seem to have short-term response to interferon therapy with improvement of proteinuria. The aim of this study was to assess the long-term response of patients with HBV-related glomerulonephritis to interferon alfa therapy. Methods: All patients with chronic hepatitis 8 and glomerulonephritis who were treated with interferon alfa at the National Institutes of Health between 1985 and 1993 were assessed. Results: Of the 15 patients treated, 8 (53%) had a long term serological response with sustained loss of serum hepatitis 8 e antigen and HBV DNA. After 1-7 years of follow-up, all 8 responders have normal serum amino-transferase transferase levels and 5 are hepatitis 8 surface antigen negative. Seven of the responders also showed a gradual but marked improvement in proteinuria. In contrast, the 7 nonresponders continued to have evidence of active renal disease and 1 required long-term dialysis therapy. All 8 responders had membranous glomerulonephritis, whereas 4 of 7 nonresponders had membranoproliferative glomerulonephritis. Conclusions: Interferon alfa therapy resulted in long-term remission in liver disease in 8 of 15 patients with chronic hepatitis B and glomerulonephritis. This response was accompanied by significant improvement in markers of renal disease in the majority of patients.