Hepatitis Virus and Extrahepatic Manifestations. Skin, Mucosa, Muscle, and Hematopoietic Organs.

Key words: hepatitis A virus (HAV), hepatitis B virus (HBV), hepatitis C virus (HCV), lichen planus, oral can-cerIn troduc tion Hepatitis viruses induce not only chronic liver diseases, but also impairment of other organs and tissues, resulting in symptomatic manifestations not associated with liver diseases (1, 2).Such lesions are referred to as extrahepatic manifestations.Especially, hepatitis C virus (HCV) is involved in various extrahepatic manifestations (Table1 ).Extrahepatic manifestations induced by hepatitis A virus (HAV)include: acute renal failure, disorders in hematopoietic organs (pure red cell aplasia, aplastic anemia, hemolytic anemia, idiopathic thrombocytopenic purpura), myocardiopathy, meningitis, meningoencephalitis, Guillain-Barre syndrome, pancreatitis, induction of autoimmune hepatitis, and impaired glucose tolerance.In contrast, extrahepatic manifestations in-duced by hepatitis B virus (HBV) include: nephropathy, arteritis nodosa, Gianotti disease, chronic rheumatoid arthritis, Schonlein-Henoch purpura, polymyositis, and disorders of hematopoietic organs (thrombocytopenia, aplastic anemia).Moreover, extrahepatic manifestations induced by hepatitis C virus (HCV) include : cryoglobulinemia, membranoproliferative glomerulonephritis, porphyria cutanea tarda, Sjogren's syndrome, malignant lymphoma, myositis, oral cancer, lichen planus, Mooren corneal ulcer, myocardiopathy, diabetes mellitus, chronic thyroiditis, and interstitial pneumonia.Furthermore, our previous studies suggested that HCVmight be closely involved in the development of oral cancer.It is considered that viruses themselves or hosts' immuneresponses are involved in the development of extrahepatic manifestations after hepatitis viral infection.However, the etiology for the most part, remainsunclear.Amongthese extrahepatic manifestations, the present study describes those that develop in the skin, mucosae, muscle, and hematopoietic organs, involving HCV, in particular.