Neuromuscular Disorders Associated With Hepatitis B Virus Infection

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http://journals.lww.com/jcnmd/Abstract/2011/09000/Neuromuscular_Disorders_Associ\

ated_With_Hepatitis.3.aspx

Journal of Clinical Neuromuscular Disease:

September 2011 - Volume 13 - Issue 1 - pp 26-37

doi: 10.1097/CND.0b013e3181df2b2b

Review Article

Neuromuscular Disorders Associated With Hepatitis B Virus Infection

Stübgen, Joerg- MD

Abstract

Approximately 400 million worldwide are chronically infected with the hepatitis

B virus (HBV). During the course of illness, approximately 20% of patients

develop disease manifestations outside the liver. Neuropathy develops in

approximately 5% of patients with chronic HBV infection and rarely during acute

HBV infection. The pathogenesis of the various HBV-associated neuropathy

syndromes possibly involves deposition of immune complexes in nerves or blood

vessel walls. Direct viral infection of nerves has not been demonstrated.

Management entailed supportive care with antiviral and immunomodulatory

treatment as clinically indicated. Rare cases of muscle disease, mostly

inflammatory myopathy, have been associated with HBV infection. Presumably,

HBV-associated antigens trigger immune mechanisms directed against components of

muscle tissue. There is no evidence of replicative virus infection of muscle

fibers. Management entailed immunomodulatory treatment, occasionally with

anti-HBV therapy. Physicians should be aware that HBV infection has the

potential to trigger presumed immune-mediated neuromuscular syndromes.