Glomerulonephritis, the Most Common Extrahepatic Manifestation Caused by Hepatitis B Virus Infection: Possible Pathogenesis and Therapeutic Approaches

Hepatitis B virus (HBV) infection is a significant global public health concern. The virus exhibits broad tropism and can affect various organs and systems besides the liver. Among various HBV-related extrahepatic diseases, glomerulonephritis, represented by membranous nephropathy, is the most common type. HBV-associated membranous nephropathy (HBV-MN) typically manifests as nephrotic syndrome with an insidious onset. Notably, 30% of adult patients progress to renal failure, underscoring the urgency for early diagnosis and intervention. Current challenges encompass underdiagnosis risks in occult HBV-MN, lack of stratified guidance in treatment strategies, marked heterogeneity of immune complex deposition patterns in HBV-GN, and incompletely characterized pathogenic mechanisms. This review synthesizes current understanding of HBV-MN, covering clinical manifestations, therapeutic interventions, and mechanistic insights into the signaling pathways involved in its pathogenesis.