HBs Ag positive person may have all of the following associated Renal lesions, Except:
**Core Concept**
HBsAg positivity is associated with hepatitis B virus (HBV) infection, which can cause a range of renal lesions due to immune complex deposition, direct viral injury, and secondary effects on renal function.
**Why the Correct Answer is Right**
HBV infection can lead to membranous nephropathy, membranoproliferative glomerulonephritis, and focal segmental glomerulosclerosis (FSGS) through the deposition of HBV antigens and antibodies in the glomeruli. Additionally, HBV can cause direct viral injury to renal cells, leading to acute kidney injury and chronic kidney disease. The HBV-related renal lesions are often associated with elevated serum HBsAg levels.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because membranous nephropathy is indeed associated with HBsAg positivity, characterized by the deposition of immune complexes containing HBsAg and anti-HBs antibodies in the glomerular basement membrane.
**Option B:** This option is incorrect because membranoproliferative glomerulonephritis is also associated with HBsAg positivity, characterized by the deposition of HBV antigens and antibodies in the glomeruli, leading to glomerular proliferation and basement membrane thickening.
**Option C:** This option is incorrect because FSGS is also a recognized renal lesion in HBsAg-positive individuals, likely due to the direct viral injury to renal cells and the deposition of HBV antigens and antibodies in the glomeruli.
**Clinical Pearl / High-Yield Fact**
HBV-related renal lesions often present with proteinuria, hematuria, and progressive renal dysfunction, and the presence of HBsAg positivity should prompt a renal biopsy to confirm the diagnosis.
**Correct Answer: D.**