Prevalence of renal abnormalities in chronic HBV infection: the HARPE study

Liver Int. 2015 Jan;35(1):148-55. doi: 10.1111/liv.12480. Epub 2014 Mar 3.

Abstract

Background & aims: Few data are available on the prevalence of renal abnormalities in chronic hepatitis B virus (HBV)-infected patients. The multicentric cross-sectional HARPE study evaluated the prevalence of kidney disease indicators, in chronic HBV surface antigen carriers patients (HBsAg+) with active or inactive infection.

Patients and methods: Two hundred and sixty-eight HBsAg+ adult patients, naïve of any oral antihepatitis B virus treatment were prospectively included over 2 years. Data for renal assessment were collected once from patient files. Univariate tests and multiple linear regressions were performed with the SAS software, version 8.02 (SAS, Inc., Cary, NC, USA).

Results: Among the 260 patients analysed, 58% were men, the mean age was 42 ± 14 years, 59.6% were inactive carriers whereas 47 patients, mostly active, were about to start an antiviral therapy. Prevalence of proteinuria, haematuria, glycosuria, uninfectious leukocyturia was 38.1%, 20.6%, 3.9% and 9% respectively. According to the international definition, a total of 64.6% of patients were found to have kidney disease. Diabetes, hypertension and dyslipidaemia were observed, respectively, in 4.6%, 9.2% and 38.8% patients. There were no significant differences in these results within the three subgroups.

Conclusion: Renal abnormalities are highly prevalent in our population and pre-exist before the initiation of any antihepatitis B virus treatment. This emphasizes the need for: (i) a baseline renal evaluation in all HBs antigen-positive patients; (ii) a regular renal monitoring before and during antihepatitis B virus treatment to diagnose and manage renal impairment and adjust antihepatitis B virus treatment doses to renal function when necessary.

Keywords: hepatitis B virus; international definition; kidney disease; nucleos(t)idic analogues.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Biomarkers / blood*
  • Creatinine / blood
  • Cross-Sectional Studies
  • Diabetes Mellitus / epidemiology
  • Dyslipidemias / epidemiology
  • Female
  • Hepatitis B Surface Antigens / blood*
  • Hepatitis B, Chronic / complications*
  • Hepatitis B, Chronic / epidemiology*
  • Humans
  • Hypertension / epidemiology
  • Kidney Diseases / epidemiology*
  • Kidney Diseases / pathology
  • Linear Models
  • Male
  • Middle Aged
  • Prevalence
  • Prospective Studies
  • Proteinuria / blood

Substances

  • Biomarkers
  • Hepatitis B Surface Antigens
  • Creatinine