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Extrahepatic Manifestations of Chronic Hepatitis B Infection

  • Hepatitis B (JK Lim, Section Editor)
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Abstract

Purpose of Review

Hepatitis B virus (HBV) is responsible for over 350 million chronic carriers, 50% of whom will die prematurely from cirrhosis and hepatocellular carcinoma associated with T cell-mediated cytopathic immune clearance of the virus occurring over lifetime. Around 20% of acute and chronic HBV carriers are experiencing a great range of extrahepatic manifestations related to complex immunological mechanisms.

Recent Findings

Extrahepatic manifestations are due to circulating immune complexes or possibly local inflammation triggered by viral antigens and activating the complement cascade. Their mechanism and severity are unrelated to progression of liver disease. The exact viral trigger antigens remain elusive and the most likely candidates could be hepatitis B e antigen.

The spectrum of the lesion includes acute infection serum sickness, vasculitis including, polyarteritis nodosa and the most affected organs are skin, large joints, muscles, and kidneys.

Summary

Prompt awareness of these extrahepatic manifestations is now of paramount importance, since well-tolerated nucleoside analogues devoid of resistance are capable of inhibiting HBV replication and have proven not only lifesaving but remarkably also curative, like for PAN, turning as the most prophetic illustration of HBV cure.

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  1. Service d’Hépatologie, Groupement Hospitalier Nord, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, 103 Grande Rue de la Croix-Rousse, 69317, Lyon Cedex 04, France

    Victor Virlogeux & Christian Trépo

  2. Université Claude Bernard Lyon 1, Lyon, France

    Victor Virlogeux & Christian Trépo

  3. Inserm 1052, CNRS 5286, Centre Léon Bérard, Centre de Recherche en Cancérologie de Lyon, F-69008, Lyon, France

    Victor Virlogeux & Christian Trépo

  4. Department of Hepatology, Clinical Research Center (CRC), Groupement Hospitalier Nord, Hospices Civils de Lyon, Lyon, France

    Victor Virlogeux

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Virlogeux, V., Trépo, C. Extrahepatic Manifestations of Chronic Hepatitis B Infection. Curr Hepatology Rep 17, 156–165 (2018). https://doi.org/10.1007/s11901-018-0403-0

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