Sylvia Dražilová
Extrahepatic manifestations of chronic viral hepatitis are frequent, especially in patients with chronic hepatitis C. Membranous glomerulonephritis and polyarteritis nodosa are the most frequent extrahepatic manifestation in chronic hepatitis B. About 70 % of patients with chronic HCV infection suffer from extrahepatic manifestation. Mixed cryoglobulinemia, membranoproliferative glomerulonephritis, leucocytoclastic vasculitis, lichen planus and non Hodgkin lymphoma are the most frequent extrahepatic manifestations of chronic hepatitis C. Vasculitis and mixed cryoglobulinemia are frequently diagnosed in patients with advanced fibrosis and cirrhosis. Antiviral therapy, immunosuppressive treatment (or its combination in HBV patients) is used for the treatment of extrahepatic manifestations. Plasmapheresis is indicated in patients with vasculitis of high grade with circulating immunocomplexes.