AbstractRituximab occasionally induces reactivation of hepatitis C virus (HCV) in patients with resolved HCV infection, sometimes with fatal consequences. As rituximab has become one of the first-line therapies for the treatment of phospholipase A2 receptor (PLA2R)-associated membranous nephropathy (MN) and is more widely used, there is a lack of studies reporting the effectiveness and safety of rituximab in patients with PLA2R-associated MN and resolved HCV infection.

。由于利妥昔单抗已成为治疗磷脂酶A2受体（PLA2R）相关膜性肾病（MN）的一线治疗方法之一，并且使用范围更广，因此缺乏研究报道利妥昔单抗在PLA2R相关MN患者中的有效性和安全性，并解决了HCV感染。

A single-center retrospective study was conducted on PLA2R-associated membranous nephropathy (MN) patients who were HCVAb positive but HCV-RNA negative and treated with rituximab. A total of 598 adult patients with PLA2R-associated MN who underwent rituximab therapy were screened. General clinical information, including gender, age, pathological data, and previous treatment plans, was collected from medical records.

对HCVAb阳性但HCV-RNA阴性并接受利妥昔单抗治疗的PLA2R相关性膜性肾病（MN）患者进行了单中心回顾性研究。共筛查了598名接受利妥昔单抗治疗的PLA2R相关MN成年患者。从病历中收集一般临床信息，包括性别，年龄，病理数据和以前的治疗计划。

Routine blood tests, liver and kidney function assessments, blood lipid profiles, 24-h urine protein levels, anti-PLA2R antibody titers, circulating B-cell counts, and HCV viral loads were measured at the time of rituximab infusion and repeated at intervals of 1–3 months post-rituximab administration.

在利妥昔单抗输注时测量常规血液检查，肝肾功能评估，血脂谱，24小时尿蛋白水平，抗PLA2R抗体滴度，循环B细胞计数和HCV病毒载量，并在利妥昔单抗给药后1-3个月间隔重复。

A total of 8 patients were enrolled, with a median follow-up period of 19.00 (range: 16.00–25.25) months. Among the 8 patients, 5 were male, and the mean age was 50.13 ± 4.29 years. Histological findings indicated that tubuloreticular inclusions, mesangial deposits, intramembranous deposits, and subendothelial deposits were not observed in any of the 8 patients.

共纳入8例患者，中位随访时间为19.00（范围：16.00-25.25）个月。。组织学检查结果表明，在8例患者中均未观察到肾小管包涵体，系膜沉积物，膜内沉积物和内皮下沉积物。

The overall 1-year remission rate for these patients was 75%, accompanied by a significant reduction in proteinuria. Additionally, blood albumin levels increased significantly, and renal function remained stable. No increase in HCV viral .

这些患者的总体1年缓解率为75%，伴随着蛋白尿的显着减少。此外，血白蛋白水平显着升高，肾功能保持稳定。HCV病毒没有增加。

IntroductionHepatitis C virus (HCV) infection is a global health problem, with an estimated 71 million people chronically infected with HCV. In 2015, the global incidence of HCV was 23.7 cases per 100,000 population, and the estimated number of new diagnoses of HCV infection in 2015 was 17.5 million1.

引言丙型肝炎病毒（HCV）感染是一个全球健康问题，估计有7100万人长期感染HCV。。

Despite the availability of effective anti-HCV drugs, there is a risk for reactivation of HCV in patients with resolved HCV infection with immunosuppressive therapy2,3.It has been demonstrated that although rituximab greatly improved the prognosis of patients with hematological malignancies and rheumatoid arthritis, it is also associated with HCV reactivation4,5.

尽管有有效的抗HCV药物可用，但通过免疫抑制治疗解决HCV感染的患者存在HCV再激活的风险2,3。已经证明，尽管利妥昔单抗大大改善了血液系统恶性肿瘤和类风湿性关节炎患者的预后，但它也与HCV再激活有关4,5。

Recently, rituximab has emerged as an effective treatment option for patients with phospholipase A2 receptor (PLA2R) associated membranous nephropathy (MN)6. However, despite the increasing use of rituximab, there is a lack of studies related to HCV reactivation in patients with PLA2R associated MN and resolved HCV infection receiving rituximab.

最近，利妥昔单抗已成为磷脂酶A2受体（PLA2R）相关膜性肾病（MN）患者的有效治疗选择6。然而，尽管利妥昔单抗的使用越来越多，但缺乏与PLA2R相关MN患者HCV再激活相关的研究，并且接受利妥昔单抗治疗的HCV感染得到解决。

With the increased use of rituximab in patients with PLA2R associated MN, there is an urgent need to determine the risk of HCV reactivation in these populations. Therefore, we included a group of patients with PLA2R associated MN in combination with resolved HCV infection treated with rituximab to determine the efficacy and safety of rituximab treatment in these patients, especially the risk of HCV reactivation.MethodsStudy design and patientsThis is a retrospective study.

随着利妥昔单抗在PLA2R相关MN患者中的使用增加，迫切需要确定这些人群中HCV再激活的风险。因此，我们纳入了一组PLA2R相关MN患者，并结合利妥昔单抗治疗的HCV感染消退，以确定利妥昔单抗治疗这些患者的疗效和安全性，尤其是HCV再激活的风险。方法研究设计和患者这是一项回顾性研究。

A total of 598 adult patients with PLA2R associated MN who received rituximab at the First Affiliated Hospital of Zhengzhou University from January 2019 to December 2021 were screened. We identified 8 cases of PLA2R associated MN with resolved HCV infection. A diagnosis of resolved HCV infection was seru.

对2019年1月至2021年12月在郑州大学第一附属医院接受利妥昔单抗治疗的598例PLA2R相关MN成年患者进行了筛查。我们确定了8例PLA2R相关MN并解决了HCV感染。已解决HCV感染的诊断为seru。

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Data could be obtained upon request to the corresponding author.

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Download referencesAcknowledgementsThanks to the support of Renal Pathology Laboratory, the First Affiliated Hospital of Zhengzhou University.Author informationAuthor notesThese authors contributed equally: Xiaodan Li and Dongxu Song.Authors and AffiliationsDepartment of Nephropathy, The First Affiliated Hospital of Zhengzhou University, No.

下载参考文献致谢感谢郑州大学第一附属医院肾脏病理实验室的支持。作者信息作者注意到这些作者做出了同样的贡献：李晓丹和宋东旭。作者和所属单位郑州大学第一附属医院肾病科。

1 East Jianshe Road, Zhengzhou, 450052, Henan, ChinaXiaodan Li, Dongxu Song, Yingxuan Hao, Mingjing Ren, Yanhong Guo, Yulin Wang & Lin TangDepartment of Critical Care Medicine, The First Affiliated Hospital of Zhengzhou University, No. 1 East Jianshe Road, Zhengzhou, 450052, Henan, ChinaHuayan ZhaoAuthorsXiaodan LiView author publicationsYou can also search for this author in.

中国河南省郑州市建设东路1号，450052，河南省郑州市建设东路1号郑州大学第一附属医院重症医学科，郑州市450052，河南省郑州市建设东路1号，李晓丹，宋东旭，郝英轩，任明静，郭艳红，王玉林，唐林，赵华燕作者肖丹LiView作者出版物您也可以在中搜索这位作者。

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PubMed Google ScholarContributionsL.T. and X.D.L. designed the study. X.D.L. and Y.X.H. made the tables and figures, and wrote the manuscript. Y.X.H., H.Y.Z and Y.L.W collected the data. Y.H.G. and M.J.R. performed the statistical analysis. L.T. revised the manuscript. D.S. collected data, made statistical analysis and wrote the revised manuscript.

PubMed谷歌学术贡献l。T、 X.D.L.设计了这项研究。十、 D.L.和Y.X.H.制作了表格和数字，并撰写了手稿。Y、 X.H.，H.Y.Z和Y.L.W收集了数据。Y、 。五十、 T.修改了手稿。D、 美国收集了数据，进行了统计分析并撰写了修订后的手稿。

All authors reviewed and edited the manuscript and approved the final version of the manuscript.Corresponding authorCorrespondence to.

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Reprints and permissionsAbout this articleCite this articleLi, X., Song, D., Hao, Y. et al. Efficacy and safety of rituximab in patients with PLA2R associated membranous nephropathy and resolved HCV infection.

转载和许可本文引用本文Li，X.，Song，D.，Hao，Y。等人。利妥昔单抗在PLA2R相关性膜性肾病和解决HCV感染患者中的疗效和安全性。

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KeywordsPLA2R associated membranous nephropathyPhospholipase A2 receptorResolved HCV infectionRituximab

关键词PLA2R相关膜性肾病磷脂酶A2受体解决HCV感染利妥昔单抗

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