Hematological complications in patients with viral hepatitis

Abstract

Over 2000 new hepatitis C virus (HCV) infections, 1500 new hepatitis B virus (HBV) infections and 100 new hepatitis A virus (HAV) infections are registered in Poland annually. Hepatotropic viruses induce not only liver damage but also extrahepatic manifestations affecting other organs mainly due to autoimmune reactions. Extrahepatic manifestations occur in about 40% of patients suffering from chronic HCV and in 10–20% patients with chronic HBV. The majority of hematological complications in patients with viral hepatitis results from chronic antigen stimulation of B lymphocytes that impairs the immune system and leads to its genetic aberrations. Hematological complications may be the first symptoms of viral hepatitis that otherwise may remain clinically silent. Therefore, the haematologist may be the first one who diagnose viral hepatitis. Hematological complications of all viral hepatitis (A, B, C) comprise of cryoglobulinemia, thrombocytopenia, rarely aplastic anaemia and haemolytic anaemia. B-cell non-Hodgkin lymphomas occur in the course of HBV and HCV, and monoclonal gammapathies mainly of HCV. Close cooperation between hematologist and hepatologist is necessary to provide optimal management of patients with hepatitis and hematological complications.
Hematologia 2011; 2, 2: 162–171