Published online Sep 18, 2015. doi: 10.4254/wjh.v7.i20.2241
Peer-review started: May 30, 2015
First decision: June 18, 2015
Revised: July 8, 2015
Accepted: July 29, 2015
Article in press: August 3, 2015
Published online: September 18, 2015
Processing time: 109 Days and 22.6 Hours
Hepatitis B virus (HBV) is classically considered to be hepatotropic, but accumulating evidences strongly support its extra-hepatotropic nature too. HBV nucleic acids and proteins have long been reported in a variety of extra-hepatic tissues. Of these, HBV has been studied in details in the peripheral blood mononuclear cells (PBMCs), due to its accessibility. From these studies, it is now well established that PBMCs are permissive to HBV infection, replication, transcription and production of infective virions. Furthermore, molecular evolutionary studies have provided definite evidences towards evolution of HBV genome in PBMCs, which is independent of evolution occurring in the liver, leading to the emergence and selection of compartment specific escape variants or drug resistant strains. These variants/resistant strains of HBV remain restricted within the PBMCs and are rarely detected in the serum/plasma. In addition, HBV infected PBMCs have been reported to be directly transmitted through intrauterine modes, and this infection does not correlate significantly with serum HBV surface antigen or HBV DNA markers. This editorial briefly reviews the current knowledge on this topic, emphasizes and delineates the gaps that are required to be filled to properly understand the biological and clinical relevance of extrahepatic tropism of HBV.
Core tip: This editorial discusses the phenomenon of compartmentalization of hepatitis B virus (HBV) in the peripheral blood mononuclear cells, their clinical relevance in emergence of escape mutants/drug resistant strains and also in transmission of infection through intrauterine routes. Referring to findings reported in some of the recently published articles on this topic, possible implications of compartmentalization is discussed with a focus on knowledge gaps that need to be filled to better understand HBV biology and pathology.