Multiple cerebral arterial stenosis associated with hepatitis B virus infection

There are conflicting findings regarding the association between hepatitis B (HB) virus (HBV) infection and atherosclerosis. A 34-year-old man was admitted for transient dysarthria and facial palsy. Ten years previously he had been diagnosed with HBV infection and treated with lamivudine (100 mg/day). Reactivation of HBV was detected 6 months before this recent admission. Serologic tests revealed that he was positive for HB early antigen, HB surface antigen, and anti-HB core. Brain magnetic resonance images were normal, but magnetic resonance angiograms revealed severe stenosis of the right middle cerebral artery, both external carotid arteries, and the basilar artery. This case report reveals that a young patient with reactivated HBV developed multiple arterial stenoses even though he had no risk factors for this disease.