Effect of treatment with direct-acting antiviral agents on the prognosis of extrahepatic diseases in patients with hepatitis C / 临床肝胆病杂志

The prognosis of patients with hepatitis C virus infection depends not only on liver lesions， but also on extrahepatic sequelae. Direct-acting antiviral agents （DAAs）， as the first-line drugs in the treatment of hepatitis C， have helped more and more patients achieve sustained virologic response and clinical cure， but its effect on the prognosis of extrahepatic diseases remains unclear. This article reviews the effect of DAAs treatment on the prognosis of extrahepatic diseases in patients with hepatitis C and points out that long-term follow-up monitoring is still required for patients with hepatitis C after cure.

Manifestaciones extrahepáticas de la infección por el virus de la Hepatitis B / Extrahepatic Manifestations of Hepatitis B

La hepatitis crónica, la cirrosis hepática y el carcinoma hepatocelular son las manifestaciones clásicas de la infección crónica por hepatitis B, pero hasta el 20% de los pacientes se presentan con manifestaciones extrahepáticas de la infección. Las principales afecciones extrahepáticas son la poliarteritis nodosa y la enfermedad glomerular; sin embargo, los pacientes pueden consultar con manifestaciones cutáneas, reumatológicas, hematológicas y neurológicas. En este artículo presentamos el caso de una mujer con hepatitis B crónica, quien debutó con una exacerbación/flare acompañada de vasculitis leucocitoclástica y artritis. Los clínicos debemos estar atentos a la presentación extrahepática de la hepatitis B, ya que esta puede asociarse con complicaciones severas y además requerir tratamiento antiviral independiente de la indicación de tratamiento por su enfermedad hepática.

Chronic hepatitis, liver cirrhosis and hepatocellular carcinoma are the classic manifestations of chronic hepatitis B infections, but up to 20% of patients present extrahepatic manifestations of the infection. The most common extrahepatic presentations are polyarteritis nodosa and glomerular disease, but patients can also develop cutaneous, rheumatological, hematological and neurological manifestations. In this article we present the case of a woman with chronic hepatitis B whose initial manifestation was a flare-up accompanied by leukocytoclastic vasculitis and arthritis. Clinicians should be aware of extrahepatic presentations of hepatitis B because they can be associated with severe complications and may also require separate antiviral treatment independent of that indicated for liver disease