A Case Report of Alloimmune Hepatitis after Direct-acting Antiviral Treatment in a Liver Transplant Patient

Choi, Catherine; Botros, Youssef; Shah, Jamil M.; Xue, Pei; Jones, Anja; Galan, Mark; Olivo, R; Niazi, Mumtaz; Paterno, Flavio; Guarrera, James V.; Pyrsopoulos, Nikolaos

doi:10.14218/jcth.2020.00062

Cited by 3 publications

(4 citation statements)

References 20 publications

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“…We may argue that recent moderate ischemic‐reperfusion injury with EAD, kidney failure and active HCV viral replication made this steatotic graft most vulnerable, playing a role in the drug‐induced injury. Noteworthy, in 2020 Choi C et al 32 published a case report of alloimmune hepatitis after 2 weeks of therapy with SOF/VEL/VOX. The patient had undergone LT with active HCV viremia 3 months before and received an HCV antibody and HBcAb‐positive graft.…”

Section: Discussionmentioning

confidence: 99%

“…In this case, authors concluded relating the alloimmune hepatitis to an immune system imbalance induced by the DAA regimen in a patient who already suffered from vitiligo. This highlights that every effort should be made in order to collect more data all around the world about the use of SOF/VEL/VOX after LT 31–33 …”

Section: Discussionmentioning

confidence: 99%

“…This highlights that every effort should be made in order to collect more data all around the world about the use of SOF/VEL/VOX after LT. [31][32][33] Among limitations, we acknowledge that this study is retrospective and monocentric but it is representative of several Italian regions due to the high-volume activity of our Centre. Furthermore, a viraemic control group was not included, but we reported data from our previous published cohort of HCV viraemic patients.…”

Section: Discussionmentioning

confidence: 99%

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Early post‐liver transplant use of direct‐acting antivirals in naive and NS5A inhibitor‐experienced HCV patients

Saracco

Tandoi

Maletta

et al. 2022

Journal of Viral Hepatitis

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Since the advent of direct-acting antivirals (DAAs), the Scientific Community assisted to a rapid decline of liver transplant (LT) indication for hepatitis C virus (HCV) cirrhosis. 1,2 It is estimated, however, that 58 million people suffer from chronic HCV infection across the world, with about 1.5 million new infections occurring per year, 3 and unfortunately, the World Health Organization's 2030 elimination target has been slowed down due to the coronavirus disease 2019 pandemic. 4,5 A huge amount of data about the efficacy and safety of DAAs in HCV population are now available, with an overall sustained viral response rate after 12 weeks from the end of therapy (SVR12) above 95%. [6][7][8][9][10] However, in patients with decompensated cirrhosis

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Early post‐liver transplant use of direct‐acting antivirals in naive and NS5A inhibitor‐experienced HCV patients

Saracco

Tandoi

Maletta

et al. 2022

Journal of Viral Hepatitis

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“…The process of autoantigen recognition is closely controlled by regulatory mechanisms in the normal state. The failure of these systems causes the autoimmune onslaught to begin and continue [43,44] . In AIH, immunoregulatory systems have been consistently identified as being impaired.…”

Section: Pathogenesismentioning

confidence: 99%

Role of Inflammasomes in Liver Disease and Autoimmune Hepatitis vs. Infectious Hepatitis: An Extensive Review

Gadour

Miuţescu

2023

ijirms

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Autoimmune hepatitis (AIH) is a chronic inflammatory condition characterized by periportal inflammation, increased immunoglobulins and autoantibodies, and a significant response to immunosuppression. In genetically predisposed people, an environmental contaminant is thought to induce an immune-mediated attack against liver antigens. A wide range of clinical manifestations, from chronic indolent illness to fulminant hepatic failure, can be detected, and the diagnosis necessitates the exclusion of other causes of liver disease. Corticosteroid therapy must be started early and tailored to the person. The variety of clinical symptoms, uncertainty regarding the natural history, developing notions about therapeutic end targets, and the existence of many alternative immunosuppressive drugs can confound therapeutic decisions. The ultimate aim of the desired therapy is to achieve normal liver tests and tissue; however, this must be balanced against the danger of side effects. Early liver transplantation may be beneficial for decompensated patients. When therapy is started quickly and aggressively, the long-term prognosis is excellent. Our article addresses AIH and provides a thorough overview of its clinical presentation, risk factors, immunopathogenesis, modern diagnostic criteria, recent advancements in therapy, a brief discussion of AIH during pregnancy, and long-term effects on cirrhosis and hepatocellular carcinoma in patients with AIH.

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A retrospective study of prevalence and pattern of international consensus on ANA patterns among patients with hepatitis C virus infection

Hsiao

Fan

Yen

et al. 2022

PeerJ

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Background A previous study reported a 30% prevalence of various autoantibodies among patients with hepatitis C virus (HCV) infection. The International Consensus on Anti-Nuclear Antibody (ANA) Patterns was recently introduced to classify ANA patterns based on immunoassay on HEp-2 cells. There is no previous report with this newly developed classification to evaluate patients with HCV infection. The study aims to study the prevalence and pattern of ANA patterns among HCV-infected patients. Methods We retrospectively analyzed the medical records of patients with HCV infection from September 2020 to June 2021 at our institution. A positive ANA is defined as a titer of more than 1:320. We compared patient features among the positive and negative groups. Results Overall, 258 patients were enrolled—184 patients with negative ANA and 74 patients (28.7%) with positive ANA. The mean age was 67.3 in ANA positive group and 61.2 ANA negative group. Female was prominent with ANA positive and accounted for 63.5%. The most detected ANA pattern was AC-1(homogeneous) (25.9%), followed by AC-4(fine speckled) (25.2%) and AC-21(anti-mitochondrial antibody) (9.6%). In ANA positive group, we found a trend of lower HCV viral load (5.72 log10 IU/ML vs. 6.02 log10 IU/ML), lower alanine aminotransferase level (39.5 U/L vs. 44 U/L), and higher advanced fibrosis (F3 and F4) (38.5% vs. 26.1%). In addition, higher positive ANA (more than 1:640) is significantly associated with lower estimated glomerular filtration rate (eGFR) (77.76 vs. 87.94 mL/min/1.73 m2, P = 0.044). Conclusions A high prevalence (28.7%) of ANA was found in patients with chronic hepatitis C. The presence of positive ANA is not related to the severity of their hepatic manifestation. However, higher positive ANA was significantly associated with lower eGFR.

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A Case Report of Alloimmune Hepatitis after Direct-acting Antiviral Treatment in a Liver Transplant Patient

Cited by 3 publications

References 20 publications

Early post‐liver transplant use of direct‐acting antivirals in naive and NS5A inhibitor‐experienced HCV patients

Early post‐liver transplant use of direct‐acting antivirals in naive and NS5A inhibitor‐experienced HCV patients

Role of Inflammasomes in Liver Disease and Autoimmune Hepatitis vs. Infectious Hepatitis: An Extensive Review

A retrospective study of prevalence and pattern of international consensus on ANA patterns among patients with hepatitis C virus infection

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