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Human hepatitis viruses-associated cutaneous and systemic vasculitis.

Chrong-Reen Wang1, Hung-Wen Tsai2

  • 1Department of Internal Medicine, National Cheng Kung University Hospital, Tainan 70403, Taiwan. wangcr@mail.ncku.edu.tw.

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Human hepatitis viruses (HHVs) can cause liver inflammation and extrahepatic complications like vasculitis. Antiviral therapy is recommended for HBV and HCV-related vasculitis alongside corticosteroids.

Keywords:
Antiviral therapyCryogo-bulinemic vasculitisHepatitis B virusHepatitis C virusHuman hepatitis virusesPolyarteritis nodosa

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Area of Science:

  • Hepatology and Virology
  • Immunology and Infectious Diseases

Background:

  • Human hepatitis viruses (HHVs) cause liver inflammation, with some leading to chronic disease, cirrhosis, and cancer.
  • HHV infections can manifest outside the liver, notably as cutaneous and systemic vasculitis.
  • Mechanisms include direct viral invasion, immune complex damage, and autoimmune responses, with cryoglobulinemic vasculitis and polyarteritis nodosa linked to chronic HHV.

Purpose of the Study:

  • To review the role of human hepatitis viruses in the pathogenesis of vasculitis.
  • To discuss the extrahepatic manifestations of HHV infections, focusing on vasculitis.
  • To outline current therapeutic considerations for HHV-associated vasculitis.

Main Methods:

  • Literature review of HHV infections and their association with vasculitis.
  • Analysis of pathogenic mechanisms linking viral infections to vascular inflammation.
  • Examination of clinical presentations and treatment strategies for HHV-related vasculitis.

Main Results:

  • Hepatitis B virus (HBV) and Hepatitis C virus (HCV) are implicated in chronic hepatitis and associated vasculitis.
  • Various HHVs, excluding hepatitis delta virus, contribute to vasculitis through direct invasion, immune complexes, or autoimmunity.
  • Cryoglobulinemic vasculitis and polyarteritis nodosa are frequently associated with chronic HBV and HCV infections.

Conclusions:

  • HHV infections, particularly chronic HBV and HCV, are significant contributors to systemic vasculitis.
  • Antiviral therapy is crucial for HBV and HCV-related vasculitis, often in conjunction with immunosuppressants.
  • Further research is needed to establish definitive therapeutic guidelines for all forms of HHV-associated vasculitis.