Three cases of autoimmune hepatitis in HIV-infected patients.
Autoimmune hepatitis (AIH) is an uncommon liver disease that has previously been reported only 4 times in HIV-infected patients. Our report describes 3 new cases of AIH, 2 probable, and 1 definite. Two of these cases developed while the patient was virologically suppressed on antiretroviral therapy. Liver biopsy findings were critical in establishing the diagnosis of AIH. Because abnormal liver function tests in HIV-positive patients are often ascribed to antiretroviral medications and/or comorbid conditions, AIH may be underdiagnosed in this population. These cases underscore the value of liver biopsy in evaluating hepatitis of unclear etiology in HIV-positive patients. The clinical course of these cases also suggests that standard immunosuppressive therapy for AIH remains the optimal treatment regimen, even in HIV-positive patients.
Puius
Yoram A
YA
Division of Infectious Diseases, Department of Pathology, Columbia University Medical Center, 630 West 168th Street, New York, NY 10032, USA.
Dove
Lorna M
LM
Brust
Douglas G
DG
Shah
Deena P
DP
Lefkowitch
Jay H
JH
D000328:Adult; D000368:Aged; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D015551:Autoimmunity / Q000276:immunology; D001706:Biopsy; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006678:HIV / Q000276:immunology*; D015483:HIV Antibodies / Q000032:analysis*; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D019693:Hepatitis, Autoimmune / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged
D044966:Anti-Retroviral Agents; D015483:HIV Antibodies; D007166:Immunosuppressive Agents