Pleural Effusion Related to Chronic Hepatitis B Virus Reactivation: A Rare Association

Eur J Case Rep Intern Med. 2021 Feb 12;8(3):002270. doi: 10.12890/2021_002270. eCollection 2021.


Despite worldwide vaccination campaigns, hepatitis B virus (HBV) infection remains a major public health problem. The natural history ranges from asymptomatic infection to severe liver injury or failure, chronic complications or reactivation episodes. The effects of HBV on the organism are immunomediated, possibly triggering extrahepatic manifestations. Since 1971, only a few cases of pleural effusion related to HBV infection have been described. We report HBV-associated pleural effusion occurring during a viral reactivation episode. Antiviral treatment directed towards pleural effusion related to HBV infection should be dictated by underlying liver disease severity and not pleural effusion severity.

Learning points: In the presence of pleural effusion of unknown origin, especially if with simultaneous acute hepatitis, a viral aetiology should be suspected and pursued.The severity of liver disease and not the pleural effusion should guide antiviral treatment.

Keywords: Hepatitis B virus; extrahepatic manifestations; pleural effusion; viral reactivation.