Current Hepatology Reports

, Volume 17, Issue 3, pp 156–165 | Cite as

Extrahepatic Manifestations of Chronic Hepatitis B Infection

  • Victor Virlogeux
  • Christian Trépo
Hepatitis B (JK Lim, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Hepatitis B


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.


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.


Hepatitis B virus Extrahepatic manifestations Vasculitis Glomerulonephritis Polyarteritis nodosa Serum-like sickness syndrome 


Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Authors and Affiliations

  1. 1.Service d’Hépatologie, Groupement Hospitalier NordHôpital de la Croix-Rousse, Hospices Civils de LyonLyon Cedex 04France
  2. 2.Université Claude Bernard Lyon 1LyonFrance
  3. 3.Inserm 1052, CNRS 5286, Centre Léon Bérard, Centre de Recherche en Cancérologie de LyonLyonFrance
  4. 4.Department of Hepatology, Clinical Research Center (CRC), Groupement Hospitalier NordHospices Civils de LyonLyonFrance

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