BESIDES THE LIVER, WHAT DOES THE VIRUS OF HEPATITIS ATTACK?

Alpert E; Jackson D; Heart Lung, 1982 Mar-Apr, 11:2, 177-80

I have reviewed some of the clinical and pathogenetic features of the extrahepatic syndromes of viral hepatitis B. They are important for three reasons: First, it is important to be able to reassure the patient with acute viral hepatitis that the troubling symptoms which he frequently fears are due to rheumatoid arthritis, are self-limited, are benign, and will disappear. Second, these syndromes will occur with occult liver disease or with no active liver disease. Frequently, patients will consult a dermatologist for a rash or a rheumatologist for arthritis. They will see a clinical immunologist for a severe vasculitis or a nephrologist for nephritis. They will have no apparent evidence of liver disease, and the etiologic agent will not be discovered unless it is searched for, that is, unless one is aware that an occult infection with the hepatitis B virus can cause these syndromes. The third important reason is that all of these syndromes previously have been thought to be idiopathic; several of them have been rather severe and even fatal. Now, with the advent of potential antiviral therapy for viral hepatitis, it becomes important to make a correct diagnosis because now, for the first time, one can think about antiviral therapy for some of these serious syndromes.

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