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Comorbidity of viral hepatitis and chronic spontaneous urticaria: A systematic review

P Kolkhir1,2, N Pereverzina1, O Olisova1

  • 1Division of Immune-mediated Skin Diseases, Department of Dermatology and Venereology, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation.

Allergy
|May 23, 2018
PubMed

Insights

Chronic spontaneous urticaria (CSU) is not typically linked to chronic hepatitis B (CHB) or hepatitis C (CHC) infections. Routine screening for these viral infections in CSU patients is generally not recommended unless specific risk factors are present.

Area of Science:

  • Dermatology
  • Hepatology
  • Infectious Diseases

Background:

  • Chronic viral infections, specifically hepatitis B (CHB) and hepatitis C (CHC), have been anecdotally associated with chronic spontaneous urticaria (CSU).
  • Previous literature reviews have not comprehensively assessed the prevalence of CHB and CHC in CSU patients and vice versa.

Purpose of the Study:

  • To conduct the first comprehensive literature review on the prevalence of CHB and CHC in patients with CSU.
  • To evaluate the prevalence of urticarial rash, including CSU, in patients with CHC.
  • To assess the potential link between viral hepatitis B/C and CSU.

Main Methods:

  • A systematic review of peer-reviewed literature was performed using PubMed, Web of Science, and Google Scholar.
  • Data from 32 studies were analyzed for the prevalence of CHB and CHC in CSU patients.
  • Data from 20 studies were analyzed for the prevalence of urticarial rash in CHC patients.

Main Results:

  • The prevalence of CHB and CHC markers in CSU patients is low, with less than 5% and 2% respectively.
  • Urticarial rash, including CSU, occurs in ≤3% of CHC patients.
  • Limited evidence suggests potential improvement in CSU with antiviral treatment for hepatitis, but this is not consistently reported.

Conclusions:

  • Hepatitis B/C infections appear unlikely to be a significant cause of CSU.
  • Routine screening for CHB and CHC in CSU patients is not cost-effective or clinically relevant.
  • Screening should be reserved for cases with abnormal liver function tests, risk factors, symptoms of viral hepatitis, or suspected urticarial vasculitis.

Keywords:
HBVHCVchronic spontaneous urticariareviewviral hepatitis

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