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Abstract Details
Hepatitis B Virus Infection and Extra-Hepatic Manifestations: A Systemic Disease
Am J Gastroenterol. 2022 Feb 1;117(2):253-263.doi: 10.14309/ajg.0000000000001575.
1Inflammation-Immunopathology-Biotherapy Department (DHU i2B), Sorbonne Universités, UPMC Univ Paris 06, UMR 7211, F-75005, AP-HP.
2INSERM, UMR-S 959, F-75013.
3CNRS, FRE3632, F-75005, Paris, France.
4Department of Internal Medicine and Clinical Immunology, Groupe Hospitalier Pitié-Salpêtrière, AP-HP, F-75013, Paris, France.
5Université de Paris, CRI, UMR 1149, Inserm, F-75018 Paris, France.
6Department of Hepatology, AP-HP Hôpital Beaujon, Clichy, France.
Abstract
People living with hepatitis B virus (HBV) chronic infection are exposed to high rates of liver complications including end-stage liver disease and hepatocellular carcinoma. Extrahepatic manifestations of HBV infection have long been underestimated. Several of these extrahepatic syndromes have been well described, including systemic vasculitides, glomerulonephritis, and cutaneous manifestations. Other manifestations have been more recently described such as hematological malignancies and neurological diseases. These extrahepatic manifestations are associated with significant morbidity and mortality. Although not completely understood, underlying mechanisms include HBV-induced local and systemic inflammation. Suppression of HBV replication usually improves extrahepatic manifestations. This review will discuss how HBV induces inflammation and the extrahepatic manifestations of HBV infection to guide clinical management.