{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T08:43:50Z","timestamp":1792226630925,"version":"4.4.0"},"reference-count":43,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CJASN"],"published-print":{"date-parts":[[2017,9]]},"abstract":"<jats:p>By definition, viral-associated GN indicates the direct pathogenic relationship between active viral replication and the development of acute GN. This definition is in sharp contrast to the semantic label and pathophysiologic foundation behind postinfectious GN that uniquely develops only during a period of resolved and absent active infection. The primary example of postinfectious GN are the glomerular lesions described after a pharyngeal or cutaneous streptococcal infection and do not represent the clinical or immunologic pattern seen with viral-associated GN. Hepatitis B (HBV) is the most common chronic viral infection in the world affecting &gt;400 million people which is more than double the prevalence of chronic HIV and hepatitis C carriers combined. In addition, 10%\u201320% of HBV patients may be coinfected with hepatitis C and 5%\u201310% will have coinfection with HIV. Being able to distinguish the different types of GN seen with each viral infection is essential for the practicing clinician as each virus requires its own specific antiviral therapy. HBV-induced immune complex disease with renal injury lies on one end of the spectrum of disorders that occurs after a prolonged chronic carrier state. On the opposite end of the spectrum are renal diseases that develop from acute or subacute viral infections. One important glomerular lesion in this category is the association of collapsing FSGS with acute active cytomegalovirus, Epstein\u2013Barr virus, and parvovirus B19 infection. The data supporting or disproving this relationship for each of these viruses will be discussed. A second renal manifestation of acute viral infections often occurs with many different sporadic or epidemic infections such as dengue and hantavirus and can lead to a transient proliferative GN that resolves upon viral clearance. The complex interplay of HBV and all viruses with the immune system provides conceptual lessons on the pathophysiology of immune complex GN that can be applied to all infection-related renal disease and plays an integral role in developing an approach to therapeutic intervention.<\/jats:p>","DOI":"10.2215\/cjn.09180816","type":"journal-article","created":{"date-parts":[[2016,10,18]],"date-time":"2016-10-18T22:10:08Z","timestamp":1476828608000},"page":"1529-1533","source":"Crossref","is-referenced-by-count":88,"title":["Viral-Associated GN: Hepatitis B and Other Viral Infections"],"prefix":"10.2215","volume":"12","author":[{"given":"Warren L.","family":"Kupin","sequence":"first","affiliation":[{"name":"Division of Nephrology, Miami Transplant Institute, University of Miami Miller School of Medicine, Miami, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2016,10,18]]},"reference":[{"key":"B1-20230813","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1053\/j.ackd.2012.02.014","article-title":"Infection-related glomerulonephritis: changing demographics and outcomes","volume":"19","author":"Nast","year":"2012","journal-title":"Adv Chronic Kidney Dis"},{"key":"B2-20230813","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1038\/nrneph.2009.44","article-title":"An update on acute postinfectious glomerulonephritis worldwide","volume":"5","author":"Kanjanabuch","year":"2009","journal-title":"Nat Rev Nephrol"},{"key":"B3-20230813","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1016\/j.semnephrol.2011.06.008","article-title":"Infection-related glomerulonephritis: understanding mechanisms","volume":"31","author":"Nadasdy","year":"2011","journal-title":"Semin Nephrol"},{"key":"B4-20230813","doi-asserted-by":"crossref","first-page":"826","DOI":"10.1053\/j.ajkd.2015.01.023","article-title":"Staphylococcus-related glomerulonephritis and poststreptococcal glomerulonephritis: why defining \u201cpost\u201d is important in understanding and treating infection-related glomerulonephritis","volume":"65","author":"Glassock","year":"2015","journal-title":"Am J Kidney Dis"},{"key":"B5-20230813","doi-asserted-by":"crossref","first-page":"11941","DOI":"10.3748\/wjg.v21.i42.11941","article-title":"Hepatitis B virus burden in developing countries","volume":"21","author":"Zampino","year":"2015","journal-title":"World J Gastroenterol"},{"key":"B6-20230813","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1053\/j.ackd.2015.06.003","article-title":"Glomerular Diseases Associated With Hepatitis B and C","volume":"22","author":"Gupta","year":"2015","journal-title":"Adv Chronic Kidney Dis"},{"key":"B7-20230813","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1111\/jvh.12519","article-title":"Wide variation in estimates of global prevalence and burden and death estimates from chronic HBV, HCV and coinfection with HIV in literature","volume":"23","author":"Basnayake","year":"2016","journal-title":"J Viral Hepat"},{"key":"B8-20230813","doi-asserted-by":"crossref","first-page":"456","DOI":"10.5414\/CN107615","article-title":"Clinical and pathological analysis of hepatitis B virus-related membranous nephropathy and idiopathic membranous nephropathy","volume":"78","author":"Li","year":"2012","journal-title":"Clin Nephrol"},{"key":"B9-20230813","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1159\/000077065","article-title":"Hepatitis B virus-associated nephropathy","volume":"24","author":"Bhimma","year":"2004","journal-title":"Am J Nephrol"},{"key":"B10-20230813","doi-asserted-by":"crossref","first-page":"278","DOI":"10.4149\/av_2014_03_278","article-title":"Significance of mutations in hepatitis B virus X gene for the pathogenesis of HB-associated glomerulonephritis","volume":"58","author":"Hui","year":"2014","journal-title":"Acta Virol"},{"key":"B11-20230813","first-page":"249740","article-title":"Antiphospholipase A2 Receptor Autoantibodies: A Step Forward in the Management of Primary Membranous Nephropathy","author":"Obrisca","year":"2015","journal-title":"Biomed Res Int"},{"key":"B12-20230813","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1056\/NEJMoa0810457","article-title":"M-type phospholipase A2 receptor as target antigen in idiopathic membranous nephropathy","volume":"361","author":"Beck","year":"2009","journal-title":"N Engl J Med"},{"key":"B13-20230813","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1159\/000431331","article-title":"Renal phospholipase A2 receptor in hepatitis B virus-associated membranous nephropathy","volume":"41","author":"Xie","year":"2015","journal-title":"Am J Nephrol"},{"key":"B14-20230813","doi-asserted-by":"crossref","first-page":"386","DOI":"10.3109\/01913123.2013.814738","article-title":"The clinicopathologic significance of endothelial tubuloreticular inclusions in glomerular diseases","volume":"37","author":"Lee","year":"2013","journal-title":"Ultrastruct Pathol"},{"key":"B15-20230813","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1007\/s00467-002-0978-z","article-title":"Hepatitis-B virus associated nephropathies: a clinicopathological study in 14 children","volume":"18","author":"Ozdamar","year":"2003","journal-title":"Pediatr Nephrol"},{"key":"B16-20230813","doi-asserted-by":"crossref","first-page":"1103","DOI":"10.1038\/ki.1989.307","article-title":"Membranous nephropathy in 52 hepatitis B surface antigen (HBsAg) carrier children in Taiwan","volume":"36","author":"Hsu","year":"1989","journal-title":"Kidney Int"},{"key":"B17-20230813","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1097\/00005792-199007000-00002","article-title":"Hepatitis-B-associated glomerulonephritis: pathology, pathogenesis, and clinical course","volume":"69","author":"Venkataseshan","year":"1990","journal-title":"Medicine (Baltimore)"},{"key":"B18-20230813","article-title":"Clinical and Morphologic Spectrum of Renal Involvement in Patients with HBV-Associated Cryoglobulinemia [published online ahead of print April 7, 2016]","author":"Li","year":"2016","journal-title":"Nephrology (Carlton)"},{"key":"B19-20230813","first-page":"200","article-title":"KDIGO Glomerulonephritis Work Group: Kidney Disease: Improving Global Outcomes. KDIGO Clinical Practice Guideline for Glomerulonephritis","volume":"2","year":"2012","journal-title":"Kidney Int Suppl"},{"key":"B20-20230813","first-page":"714","article-title":"Mutation in HBV RNA-dependent DNA polymerase confers resistance to lamivudine in vivo","volume":"24","author":"Tipples","year":"1996","journal-title":"Hepatology"},{"key":"B21-20230813","doi-asserted-by":"crossref","first-page":"c41","DOI":"10.1159\/000324652","article-title":"Treatment of hepatitis B virus-associated nephropathy","volume":"119","author":"Elewa","year":"2011","journal-title":"Nephron Clin Pract"},{"key":"B22-20230813","doi-asserted-by":"crossref","first-page":"821","DOI":"10.3748\/wjg.v18.i8.821","article-title":"Meta-analysis of combined therapy for adult hepatitis B virus-associated glomerulonephritis","volume":"18","author":"Zheng","year":"2012","journal-title":"World J Gastroenterol"},{"key":"B23-20230813","doi-asserted-by":"crossref","first-page":"e600","DOI":"10.1542\/peds.2010-3137","article-title":"Universal hepatitis B vaccination reduces childhood hepatitis B virus-associated membranous nephropathy","volume":"128","author":"Liao","year":"2011","journal-title":"Pediatrics"},{"key":"B24-20230813","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1016\/j.jceh.2013.06.001","article-title":"Hepatotropic viral infection associated systemic vasculitides-hepatitis B virus associated polyarteritis nodosa and hepatitis C virus associated cryoglobulinemic vasculitis","volume":"3","author":"Sharma","year":"2013","journal-title":"J Clin Exp Hepatol"},{"key":"B25-20230813","doi-asserted-by":"crossref","first-page":"446","DOI":"10.3109\/0886022X.2013.775659","article-title":"Clinical characteristics and treatment of patients with IgA nephropathy and hepatitis B surface antigen","volume":"35","author":"Sun","year":"2013","journal-title":"Ren Fail"},{"key":"B26-20230813","doi-asserted-by":"crossref","first-page":"459","DOI":"10.3109\/0886022X.2014.1001711","article-title":"Is there an association of hepatitis B virus infection with minimal change disease of nephrotic syndrome? A clinical observational report","volume":"37","author":"Zhou","year":"2015","journal-title":"Ren Fail"},{"key":"B27-20230813","first-page":"828","article-title":"Dengue-induced Acute Kidney Injury (DAKI): A Neglected and Fatal Complication of Dengue Viral Infection--A Systematic Review","volume":"25","author":"Mallhi","year":"2015","journal-title":"J Coll Physicians Surg Pak"},{"key":"B28-20230813","first-page":"57","article-title":"Dengue-associated kidney disease","volume":"3","author":"Lizarraga","year":"2014","journal-title":"J Nephropathol"},{"key":"B29-20230813","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1016\/j.jcv.2014.08.033","article-title":"Hantaviruses--globally emerging pathogens","volume":"64","author":"Kruger","year":"2015","journal-title":"J Clin Virol"},{"key":"B30-20230813","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1016\/j.micinf.2015.08.005","article-title":"Mesoamerican nephropathy: a neglected tropical disease with an infectious etiology?","volume":"17","author":"Murray","year":"2015","journal-title":"Microbes Infect"},{"key":"B31-20230813","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1053\/j.ajkd.2014.04.030","article-title":"Hantavirus infection with severe proteinuria and podocyte foot-process effacement","volume":"64","author":"Boehlke","year":"2014","journal-title":"Am J Kidney Dis"},{"key":"B32-20230813","first-page":"1","article-title":"Hemorrhagic Fever with Renal Syndrome: Pathogenesis and Clinical Picture","volume":"6","author":"Jiang","year":"2016","journal-title":"Front Cell Infect Microbiol"},{"key":"B33-20230813","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1093\/ckj\/sft002","article-title":"Viruses and collapsing glomerulopathy: a brief critical review","volume":"6","author":"Chandra","year":"2013","journal-title":"Clin Kidney J"},{"key":"B34-20230813","first-page":"469","article-title":"Virus-related glomerular diseases: histological and clinical aspects","volume":"15","author":"di Belgiojoso","year":"2002","journal-title":"J Nephrol"},{"key":"B35-20230813","doi-asserted-by":"crossref","first-page":"1166","DOI":"10.1016\/S0272-6386(00)70055-2","article-title":"Parvovirus B19 DNA in kidney tissue of patients with focal segmental glomerulosclerosis","volume":"35","author":"Tanawattanacharoen","year":"2000","journal-title":"Am J Kidney Dis"},{"key":"B36-20230813","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1053\/snep.2003.50019","article-title":"Collapsing glomerulopathy","volume":"23","author":"Schwimmer","year":"2003","journal-title":"Semin Nephrol"},{"key":"B37-20230813","doi-asserted-by":"crossref","first-page":"1054","DOI":"10.1016\/S0046-8177(86)80090-9","article-title":"Glomerulonephritis in congenital cytomegalic inclusion disease","volume":"17","author":"Beneck","year":"1986","journal-title":"Hum Pathol"},{"key":"B38-20230813","first-page":"7351964","article-title":"Infection-Related Focal Segmental Glomerulosclerosis in Children","author":"Dettmar","year":"2016","journal-title":"BioMed Res Int"},{"key":"B39-20230813","first-page":"160","article-title":"Systemic Epstein-Barr virus infection associated with membranous nephropathy in children","volume":"65","author":"Araya","year":"2006","journal-title":"Clin Nephrol"},{"key":"B40-20230813","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1093\/ckj\/sfs059","article-title":"Acute Epstein-Barr virus infection-associated collapsing glomerulopathy","volume":"5","author":"Joshi","year":"2012","journal-title":"Clin Kidney J"},{"key":"B41-20230813","doi-asserted-by":"crossref","first-page":"1207","DOI":"10.1038\/ki.2013.173","article-title":"JC polyoma virus interacts with APOL1 in African Americans with nondiabetic nephropathy","volume":"84","author":"Divers","year":"2013","journal-title":"Kidney Int"},{"key":"B42-20230813","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1016\/S0022-3476(86)80876-9","article-title":"Role of respiratory viruses in exacerbations of primary nephrotic syndrome","volume":"108","author":"MacDonald","year":"1986","journal-title":"J Pediatr"},{"key":"B43-20230813","doi-asserted-by":"crossref","first-page":"1929","DOI":"10.1007\/s00467-015-3057-y","article-title":"Viral-associated glomerulopathies in children","volume":"30","author":"Wenderfer","year":"2015","journal-title":"Pediatr Nephrol"}],"container-title":["Clinical Journal of the American Society of Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/01277230-201709000-00020","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T13:46:56Z","timestamp":1786369616000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/01277230-201709000-00020"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,10,18]]},"references-count":43,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2017]]}},"URL":"https:\/\/doi.org\/10.2215\/cjn.09180816","relation":{},"ISSN":["1555-9041","1555-905X"],"issn-type":[{"value":"1555-9041","type":"print"},{"value":"1555-905X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,10,18]]}}}