{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T10:10:03Z","timestamp":1756375803469,"version":"3.44.0"},"reference-count":15,"publisher":"SMC Media","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>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.<\/jats:p>","DOI":"10.12890\/2021_002270","type":"journal-article","created":{"date-parts":[[2021,5,25]],"date-time":"2021-05-25T09:52:37Z","timestamp":1621936357000},"source":"Crossref","is-referenced-by-count":0,"title":["Pleural Effusion Related to Chronic Hepatitis B Virus Reactivation: A Rare Association"],"prefix":"10.12890","volume":"8","author":[{"given":"Ana","family":"Oliveira","sequence":"additional","affiliation":[{"name":"ervi\u00e7o de Medicina Interna, Centro Hospitalar Universit\u00e1rio do Porto, Porto, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diana","family":"Valadares","sequence":"additional","affiliation":[{"name":"Unidade de Cuidados Interm\u00e9dios M\u00e9dicos, Servi\u00e7o de Cuidados Intensivos, Centro Hospitalar Universit\u00e1rio do Porto, Porto, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Filipe","family":"Nery","sequence":"additional","affiliation":[{"name":"Unidade de Cuidados Interm\u00e9dios M\u00e9dicos, Servi\u00e7o de Cuidados Intensivos, Centro Hospitalar Universit\u00e1rio do Porto, Porto, Portugal; Instituto de Ci\u00eancias Biom\u00e9dicas Abel Salazar, Universidade do Porto, Porto, Portugal; EpiUnit, Instituto de Sa\u00fade P\u00fablica da Universidade do Porto, Porto, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10397","published-online":{"date-parts":[[2021,2,12]]},"reference":[{"key":"10.12890\/2021_002270_ref1","doi-asserted-by":"crossref","unstructured":"<li>Jindal A, Kumar M, Sarin SK. Management of acute hepatitis B and reactivation of hepatitis B. <em>Liver Int <\/em>2013;<strong>33<\/strong>(1):164\u2013175.<\/li>","DOI":"10.1111\/liv.12081"},{"key":"10.12890\/2021_002270_ref2","unstructured":"<li>World Health Organization. Guidelines for the prevention, care and treatment of persons with chronic hepatitis B infection. Geneva: WHO; 2015.<\/li>"},{"key":"10.12890\/2021_002270_ref3","unstructured":"<li>European Centre for Disease Prevention and Control. Hepatitis B \u2013 annual epidemiological report for 2017. Solna, Sweden: ECDC; 2019. <\/li>"},{"key":"10.12890\/2021_002270_ref4","doi-asserted-by":"crossref","unstructured":"<li>Carvalhana SC, Leit\u00e3o J, Alves AC, Bourbon M, Cortez-Pinto H. Hepatits B and C prevalence in Portugal: disparity between general population and high-risk groups. <em>Eur J Gastroenterol Hepatol<\/em> 2016:<strong>28<\/strong>(6):640\u2013644. <\/li>","DOI":"10.1097\/MEG.0000000000000608"},{"key":"10.12890\/2021_002270_ref5","unstructured":"<li>European Association for the Study of the Liver. EASL 2017 Clinical Practice Guidelines on the management of hepatitis B virus infection. <em>J Hepatol<\/em> 2017;<strong>67<\/strong>:370\u2013398.<\/li>"},{"key":"10.12890\/2021_002270_ref6","doi-asserted-by":"crossref","unstructured":"<li>Gross PA, Gerding DN. Pleural effusion associated with viral hepatitis. <em>Gastroenterology<\/em> 1971;<strong>60<\/strong>(5):898\u2013902.<\/li>","DOI":"10.1016\/S0016-5085(71)80090-2"},{"key":"10.12890\/2021_002270_ref7","doi-asserted-by":"crossref","unstructured":"<li>Tabor E, Russel RP, Gerety RJ, Barker LF, Hillis WD, Jackson DR. Hepatitis B surface antigen and e antigen in pleural effusion: a case report. <em>Gastroenterology<\/em> 1977;<strong>73<\/strong>:1157\u20131159. <\/li>","DOI":"10.1016\/S0016-5085(19)31877-3"},{"key":"10.12890\/2021_002270_ref8","doi-asserted-by":"crossref","unstructured":"<li>Lee HS, Yang PM, Liu BF, Lee CL, Hsu HC, Su IJ, et al. Pleural effusion coinciding with acute exacerbations in a patient with chronic hepatitis B. <em>Gastroenterology<\/em> 1989;<strong>96<\/strong>:1604\u20131606.<\/li>","DOI":"10.1016\/0016-5085(89)90534-9"},{"key":"10.12890\/2021_002270_ref9","unstructured":"<li>Nail AMA, Gadour MOEH. Recurrent exsudative pleural effusion with flare up of chronic hepatitis B virus infection. <em>Sudan JMS<\/em> 2011;<strong>6<\/strong>(6):281\u2013283.<\/li>"},{"key":"10.12890\/2021_002270_ref10","doi-asserted-by":"crossref","unstructured":"<li>Viola C, Vineta L, Bosch J, Rod\u00e9s J. Exudative ascitis in the course of acute type B hepatitis. <em>Hepatology<\/em> 1983;<strong>3<\/strong>(6):1013\u20131015. <\/li>","DOI":"10.1002\/hep.1840030620"},{"key":"10.12890\/2021_002270_ref11","doi-asserted-by":"crossref","unstructured":"<li>Gish RG, Chang TT, Lai CL, de Man R, Gadano A, Poordad F, et al. Loss of HBsAg antigen during treatment with entecavir or lamivudine in nucleoside-na\u00efve HBeAg-positive patients with chronic hepatitis B. <em>J Viral Hepat<\/em> 2010;<strong>17<\/strong>:16\u201322.<\/li>","DOI":"10.1111\/j.1365-2893.2009.01146.x"},{"key":"10.12890\/2021_002270_ref12","doi-asserted-by":"crossref","unstructured":"<li>Liu J, Yang HI, Lee MH, Lu SN, Jen CL, Wang LY, et al. Incidence and determinants of spontaneous hepatitis B surface antigen seroclearance: a community-based follow-up study. <em>Gastroenterology<\/em> 2010;<strong>139<\/strong>:474\u2013482. <\/li>","DOI":"10.1053\/j.gastro.2010.04.048"},{"key":"10.12890\/2021_002270_ref13","doi-asserted-by":"crossref","unstructured":"<li>Kobayashi M, Hosaka T, Suzuki F, Akuta N, Sezaki H, Suzuki Y, et al. Seroclearance rate of hepatitis B surface antigen in 2112 patients with chronic hepatitis in Japan during long-term follow-up. <em>J Gastroenterol<\/em> 2014;<strong>49<\/strong>:538\u2013546.<\/li>","DOI":"10.1007\/s00535-013-0821-2"},{"key":"10.12890\/2021_002270_ref14","doi-asserted-by":"crossref","unstructured":"<li>Altinbas A, Yuksel I, Pamucku M, Ekiz F, Basar O, Yuksel O. Spontaneous HBsAg seroconversion after severe flare of chronic hepatitis B infection. <em>Ann Hepatol<\/em> 2010;<strong>9<\/strong>(2):194\u2013197.<\/li>","DOI":"10.1016\/S1665-2681(19)31662-X"},{"key":"10.12890\/2021_002270_ref15","unstructured":"<li>Katsanos KH, Kitsanou M, Manatou K, Papathanasopoulos A, Chrisodoulou DK, Tsianos EV. Spontaneous HBsAg clearance in a patient with acute hepatitis B and pleural exudates. <em>Ann Gastroenterol<\/em> 2007;<strong>20<\/strong>(2):147\u2013148. <\/li>"}],"container-title":["European Journal of Case Reports in Internal Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/download\/2270\/2556","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/download\/2270\/2557","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/download\/2270\/2557","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T09:43:11Z","timestamp":1756374191000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/view\/2270"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,12]]},"references-count":15,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.12890\/2021_002270","relation":{"has-manifestation":[{"id-type":"other","id":"1-67-2270-g2556","asserted-by":"subject"},{"id-type":"other","id":"1-67-2270-g2557","asserted-by":"subject"}],"is-part-of":[{"id-type":"other","id":"1-67","asserted-by":"subject"}]},"ISSN":["2284-2594"],"issn-type":[{"type":"electronic","value":"2284-2594"}],"subject":[],"published":{"date-parts":[[2021,2,12]]},"article-number":"17"}}