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Local and systemic autoimmune manifestations linked to hepatitis A infection

Journal Volume 86 - 2023
Issue Fasc.3 - Reviews
Author(s) M. Doulberis 1 2 3, A. Papaefthymiou 4 5, S.A. Polyzos 5, E. Vardaka 3 6, M. Tzitiridou-Chatzopoulou 3 7, D. Chatzopoulos 3, A. Koffas 8, V. Papadopoulos 9, F. Kyrailidi 3, J. Kountouras 3
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PAGES 429-436
(1) Department of Gastroenterology and Hepatology, Medical University Department, Kantonsspital Aarau, Switzerland
(2) Department of Gastroenterology and Hepatology, University of Zurich, Zurich, Switzerland
(3) Department of Internal Medicine, Second Medical Clinic, Ippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
(4) Pancreaticobiliary Medicine Unit, University College London Hospitals (UCLH), London, UK
(5) First Laboratory of Pharmacology, Aristotle University of Thessaloniki, Thessaloniki, Macedonia, Greece
(6) Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, Thessaloniki, Macedonia, Greece
(7) Department of Midwifery, University of Western Macedonia, Macedonia, Greece
(8) Barts Liver Centre, Centre for Immunobiology, Blizzard Institute, Barts & The London School of Medicine and Dentistry, QMUL, London, UK
(9) Department of Gastroenterology, University Hospital of Larissa, Larissa, Greece

Hepatitis A virus (HAV) represents a global burdening infectious agent causing in the majority of cases a self-limiting acute icteric syndrome, the outcome is related to the hepatic substrate and the potential pre-existing damage, whereas a plethora of extra-hepatic manifestations has also been reported. Despite the absence of post- HAV chronicity it has been associated with an additional burden on existing chronic liver diseases. Moreover, the induced immune response and the antigenic molecular mimicry are considered as triggering factors of autoimmunity with regional and distal impact. Diseases such as autoimmune hepatitis, Guillain-Barré syndrome, rheumatoid arthritis, Still’s syndrome, Henoch-Schönlein purpura, autoimmune hemolytic anemia, antiphospholipid syndrome, systematic lupus erythematosus or cryoglobulinemic vasculitis have been described in patients with HAV infection. Although the exact mechanisms remain unclear, this review aims to accumulate and clarify the pathways related to this linkage.

Keywords: Hepatitis A, immune response, autoimmune hepatitis, autoimmune diseases.

The authors declare that they have no conflict of interest.
© Acta Gastro-Enterologica Belgica.
PMID 37814559