To analyze the clinicopathological characteristics of hepatitis B virus-associated glomerulonephritis (HBV-GN) in adults, and to explore the effects of glomerular M-type phospholipase A2 receptor (PLA2R) expression on prognosis of HBV-associated membranous nephropathy (HBV-MN).

Thirty-one HBV-GN patients were enrolled in this study. They were divided into young group (≤35 years old) and middle-aged group (>35 years old). The clinical and pathological data were compared between the two groups. The glomerular expression of PLA2R and THSD7A were analyzed in HBV-MN patients.

HBV-GN patient were mainly nephrotic syndrome (NS), accounting for 54.8%. The main pathological manifestations of HBV-GN were MN, accounting for 77.4%. Among HBV-GN patients, 77.4% had microscopic hematuria. The young group had better renal function (P<0.05). HBsAg and HBcAg codepositions were the most common pattern in HBV-GN patients, accompanied by more than one immunoglobulins codeposition.The proportion of HBV-MN was higher in young group, and membranoproliferative glomerulonephritis were all in the middle-aged group (P<0.05). Two patients of HBV-MN were glomerular PLA2R positive (8.3%) and the IgG subtypes were mainly IgG4. One of the patients developed renal function decline after 84 months follow-up.

NS was the main clinical manifestation of HBV-GN in adults, with more microscopic hematuria. The young group had better renal function. The main pathological pattern was MN. The positive expression of PLA2R was rarely found in HBV-MN patients, but positive PLA2R expression indicated poor prognosis. The effect of PLA2R on prognosis of HBV-MN needs further study.

Hepatitis B virus-associated glomerulonephritis; Nephrotic syndrome; Membranous nephropathy; M-type Phospholipase A2 receptor; Thrombospondin Type-1 Domain-Containing 7A