Published online May 28, 2015. doi: 10.4254/wjh.v7.i9.1265
Peer-review started: December 2, 2014
First decision: December 26, 2014
Revised: January 28, 2015
Accepted: February 10, 2015
Article in press: February 12, 2015
Published online: May 28, 2015
Processing time: 170 Days and 12.7 Hours
Hepatitis B virus (HBV) infection is a disease with a highly variable course. Chronic HBV infection may cause end-stage liver disease including cirrhosis and hepatocellular carcinoma, which is the 3rd most common cause of cancer related death due to the poor prognosis. The prevalence of HBV infection is low in many countries. Still, it remains important due to the potential consequences of the disease. HBV is endemic in the Arctic with serologic markers of chronic HBV infection in up to 29% of the population in some areas in Greenland. Interestingly, Inuit populations rarely show signs of liver disease despite the fact that around half of all Inuit has been exposed to HBV and around 8% of Inuit are chronically infected with HBV. These findings have been consistent in surveys conducted for more than four decades among Arctic Inuit. We thus review HBV infection in the Arctic with focus on Greenland Inuit and compared with Inuit in Canada, Alaska and Siberia. The aspects described include epidemiology and monitoring of the disease, as well as treatment and the risk of liver cancer.
Core tip: Hepatitis B virus (HBV) is endemic in the Arctic with serologic markers of chronic HBV infection in up to 29% of the population in some areas in Greenland. Interestingly, Inuit populations in Greenland and Canada rarely show signs of liver disease as opposed to Alaskan Inuit where hepatocellular carcinoma was common before introduction of vaccination. Wheather this is related to a special favorable genotype or other host or environmental factors remains to be clarified. This paper is a review of present status.