Autoimmune hepatitis in human immunodeficiency virus-infected patients: A case series and review of the literature

查看全文 作　　者：Roongruedee [1]Chaiteerakij;Anapat [2]Sanpawat;Anchalee [3]Avihingsanon;Sombat [1]Treeprasertsuk

机构地区：[1]Department of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok 10330, Thailand;[2]Department of Pathology, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok 10330, Thailand;[3]Medical Department, The HIV Netherlands Australia Thailand Research Collaboration, Bangkok 10330, Thailand

出　　处：《World Journal of Gastroenterology》索引2019年第25卷第35期,共15页

摘　　要：BACKGROUND Abnormal liver chemistry is a common problem in human immunodeficiency virus (HIV)-infected patients. Common causes of abnormal liver enzymes in this population include viral hepatitis B/C or opportunistic infection, drug toxicity, and neoplasm. Autoimmune hepatitis is a rare cause of hepatitis in HIV-infected individuals;however, this condition has been increasingly reported over the past few years. CASE SUMMARY We present 13 HIV-infected patients (5 males and 8 females) who developed autoimmune hepatitis (AIH) after their immune status was restored, i.e. all patients had stable viral suppression with undetectable HIV viral loads, and median CD4+ counts of 557 cells/× 106 L. Eleven patients presented with chronic persistent elevation of aminotransferase enzyme levels. One patient presented with acute hepatitis and the other patient presented with jaundice. The median levels of aspartate aminotransferase and alanine aminotransferase enzymes were 178 and 177 U/mL, respectively. Elevation of immunoglobulin G levels was present in 11 (85%) patients. Antinuclear antibody and anti-smooth muscle antibody were positive in 11 (85%) and 5 (38%) patients. Liver biopsy was performed in all patients. They had histopathological findings compatible with AIH. The patients were started on prednisolone for remission induction, with good response. After improvement of the liver chemistry, the dose of prednisolone was tapered, and azathioprine was added as life-long maintenance therapy. At the last follow-up visit, all were doing well, without HIV viral rebound or infectious complications. CONCLUSION This report underscores the emergence of autoimmune hepatitis in the context of HIV infection. 关键词：AUTOIMMUNE hepatitis Human IMMUNODEFICIENCY virus Liver biopsy IMMUNOSUPPRESSION AUTOIMMUNITY ANTIRETROVIRAL therapy Case report

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Autoimmune hepatitis in human immunodeficiency virus-infected patients: A case series and review of the literature

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