Hepatitis A vaccine associated with autoimmune hepatitis.
To describe a case of probable relapsing autoimmune hepatitis associated with vaccination against hepatitis A virus (HAV). A case report and review of literature were written concerning autoimmune hepatitis in association with hepatitis A and other hepatotropic viruses. Soon after the administration of formalin-inactivated hepatitis A vaccine, a man who had recently recovered from an uncharacterized but self-limiting hepatitic illness, experienced a severe deterioration (AST 1687 U/L, INR 1.4). Anti-nuclear antibodies were detectable, and liver biopsy was compatible with autoimmune hepatitis. The observation supports the role of HAV as a trigger of autoimmune hepatitis. Studies in helper T-cell activity and antibody expression against hepatic proteins in the context of hepatitis A infection are summarized, and the concept of molecular mimicry with regard to other forms of viral hepatitis and autoimmunity is briefly explored.
Berry
P-A
PA
Medway Maritime Hospital, 31 Pentlow Street, Putney, London, SW15 1LX, United Kingdom. philaberry@hotmail.com
Smith-Laing
G
G
D001706:Biopsy; D022362:Hepatitis A Vaccines / Q000009:adverse effects*; D030041:Hepatitis A virus / Q000502:physiology; D019693:Hepatitis, Autoimmune / Q000175:diagnosis* / Q000209:etiology*; D006801:Humans; D008099:Liver / Q000276:immunology / Q000473:pathology / Q000821:virology; D008297:Male; D008875:Middle Aged
D022362:Hepatitis A Vaccines