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the isolation of the hepatitis C virus and its separation from the hepatitis B virus, membranoproliferative glomerulonephritis was considered a common immune complex-mediated manifestation of hepatitis B virus infection. However, more recent data indicate that this form of glomerulonephritis is a feature of hepatitis C virus infection rather than hepatitis B virus infection. In contrast, membranous glomerulonephritis, often with mesangial deposits and variable mesangial hypercellularity, is the glomerulopathy that is a common accompaniment of hepatitis B virus infection. Hepatitis B virus surface, core, or e antigens have been identified in the glomerular deposits. The morphology of the glomerular capillary walls is similar to the idiopathic form of membranous glomerulonephritis. A, Some degree of mesan-gial widening with increased cellularity occurs in most affected patients. B, Similarly, on immunofluorescence, uniform granular capillary wall deposits of immunoglobulin G (IgG), complement C3, and both light chains are disclosed (IgG). It sometimes is very difficult to identify mesangial deposits in this setting. C, In addition to the expected capillary wall changes, electron microscopy discloses deposits in mesangial regions of many lobules (the arrow indicates mesangial deposits; the arrowheads indicate subepithelial deposits).

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