[Autoimmune hepatitis in a HIV-HCV co-infected patient: diagnostic ant therapeutic difficulties].
BACKGROUND
Autoimmune hepatitis (AIH) is a chronic inflammatory hepatic disorder, characterized by hypergammaglobulinemia and autoantibodies. In some cases, AIH can be associated with another liver disease; such as the hepatitis C-AIH overlap syndrome, which diagnosis and treatment may be delicate.


METHODS
We report a type 1 AIH case in a HIV-HCV co-infected woman. AIH remission and HCV eradication were obtained with prednisone and interferon plus ribavirine. AIH relapse appeared with corticosteroid withdrawal and a new remission was obtained with immunosuppressive treatment associating prednisone and azathioprine, without opportunistic infection.


CONCLUSIONS
This case illustrates diagnostic and therapeutic difficulties of hepatitis C-AIH overlap syndromes in an HIV-infected patient. To our knowledge, it is the first AIH case report in a HIV-HCV co-infected patient.
Service de Médecine Interne et Maladies Infectieuses, Hôpital Saint-André, 1, rue Jean-Burguet, CHU de Bordeaux, 33075 Bordeaux cedex, France. charles.cazanave@wanadoo.fr
C
C
Cazanave
S
S
Rakotondravelo
P
P
Morlat
P
P
Blanco
F
F
Bonnet
J
J
Beylot
D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D006526:Hepatitis C / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D019693:Hepatitis, Autoimmune / Q000503:physiopathology / Q000821:virology*; D006801:Humans; D008111:Liver Function Tests; D012254:Ribavirin / Q000627:therapeutic use
D000998:Antiviral Agents; D012254:Ribavirin