Hepatitis B Virus Infection and Extra-Hepatic Manifestations: A Systemic Disease

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.

Switching to tenofovir alafenamide for nucleos(t)ide analogue‐experienced patients with chronic hepatitis B: week 144 results from a real‐world, multi‐centre cohort study

“…7,8 In addition, HBV itself plays a pivotal role in the acquisition and progression of chronic kidney disease (CKD) because of glomerular dysfunction. 9 The HBV population is ageing worldwide, and the frequency of comorbidities in this population is rising. Published articles from the United States and Hong Kong have shown an increased prevalence of hypertension, diabetes mellitus and CKD with age.…”

“…TDF causes declines in renal function and gradually reduces bone mineral density 7,8 . In addition, HBV itself plays a pivotal role in the acquisition and progression of chronic kidney disease (CKD) because of glomerular dysfunction 9 . The HBV population is ageing worldwide, and the frequency of comorbidities in this population is rising.…”

Hepatitis B virus-infection related cryoglobulinemic vasculitis. Clinical manifestations and the effect of antiviral therapy: A review of the literature

“…Subsequently, Ferri et al (15) evaluated 231 patients with MC, observing a 1.8% prevalence of HBsAg. All these data have been recently reviewed by Cacoub et al (2). HBV-DNA and a high rate of HBsAg or anti HBc antibody are found in HBV-related CV (6).…”

“…Nonetheless, HBV-DNA suppression generally improves extraepatic manifestations. Some studies on the topic have shown a comparable NAs antiviral efficacy in HBV-related CV, in addition to a link between antiviral response and CV improvement (2,(4)(5)(6). This review focuses on clinical manifestations and on the role of NAs therapy in HBV-related CV.…”

A carrier-free metal–organic hybrid nanoassembly with combination anti-viral and hepato-protective activity for hepatitis B treatment

“…21,22 Clinical studies found that the anti-HBV nucleoside analogues could effectively inhibit hepatitis B infections, but cannot completely restrain the chronic inflammation process. 23,24 In this connection, combining complementary drugs with the nucleoside anti-viral drugs to protect liver function and improve anti-HBV effects is a favorable therapeutic strategy for the treatment of hepatitis B. 25 Licorice-derived agents have been demonstrated to possess hepato-protective, anti-inflammatory, anti-oxidant and immunomodulatory effects, [26][27][28] and have already been employed in the treatment of chronic hepatitis in China and Japan.…”