Concurrent emergence of hepatitis B e antigen-negative hepatitis B virus variant and autoimmune hepatitis cured by adenine arabinoside monophosphate.
We report the case of a hepatitis B virus chronic carrier in whom features of severe autoimmune hepatitis developed concurrently with the emergence of a hepatitis Be antigen-negative variant. Corticosteroid administration failed to normalize serum transaminase activity and resulted in increased viral multiplication. Adenine arabinoside monophosphate treatment allowed simultaneous inhibition of hepatitis B virus multiplication and remission of autoimmune features. This observation indicates that hepatitis Be antigen-negative variants can induce autoimmune hepatitis and adds support to the hypothesis that autoimmune hepatitis can be triggered by hepatotropic viruses. Patients with both features should first be treated with adenine arabinoside monophosphate. This observation indicates that hepatitis Be antigen-negative variants can induce autoimmune hepatitis and adds support to the hypothesis that autoimmune hepatitis can be triggered by hepatotropic viruses. Patients with both features should first be treated with adenine arabinoside monophosphate.
Bécheur
H
H
Department of Hepatogastroenterology, Hôpital Broussais, Paris, France.
Valla
D
D
Loriot
M A
MA
Attar
A
A
Bloch
F
F
Petite
J P
JP
D000998:Antiviral Agents / Q000008:administration & dosage*; D001327:Autoimmune Diseases / Q000175:diagnosis / Q000188:drug therapy* / Q000821:virology; D002353:Carrier State / Q000175:diagnosis / Q000188:drug therapy* / Q000821:virology; D004279:DNA, Viral / Q000097:blood; D006513:Hepatitis B e Antigens; D006515:Hepatitis B virus / Q000187:drug effects / Q000235:genetics / Q000276:immunology*; D019694:Hepatitis B, Chronic / Q000175:diagnosis / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012074:Remission Induction; D001084:Vidarabine Phosphate / Q000008:administration & dosage*; D014779:Virus Replication / Q000187:drug effects
D000998:Antiviral Agents; D004279:DNA, Viral; D006513:Hepatitis B e Antigens; D001084:Vidarabine Phosphate