Autoimmune Hepatitis (AIH) in Acquired Immune Deficiency Syndrome (AIDS): A Case Report and Review of Literature

Roussel, Jordan; Pandit, Sudha; Jordan, P.; Boktor, Moheb; Knowles, Kurt; Cruz, Nester Dela; Samant, Hrishikesh

doi:10.1155/2019/5326428

Cited by 3 publications

(2 citation statements)

References 23 publications

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“…L'AIH di tipo 2 è caratterizzato dalla presenza di anticorpi anti-LKM (microsoma renale-epatico) e si presenta soprattutto nei bambini. In letteratura sono riportati case reports di AIH relativi a 35 pazienti HIV+ con diagnosi di AIH (2). La diagnosi viene posta sia attraverso criteri clinici e laboratoristici, sia per esclusione di altre cause.…”

Section: Discussioneunclassified

“…La diagnosi differenziale comprende varie condizioni, tra cui le epatiti da virus maggiori e minori, le infezioni opportunistiche, la steatosi epatica alcolica e non alcolica, e cause meno frequenti come ad esempio la colangite primitiva e le colangiopatie AIDS correlate, o la tossicità indotta da farmaci (Drug-induced Liver Injury, DILI) (1). Molto più raramente l'epatite autoimmune (AIH) rappresenta la causa di alterazione della funzionalità epatica nei pazienti con infezione da HIV (2). In letteratura i casi riportati di epatite autoimmune in pazienti con infezione da HIV sono limitati; malgrado la bassa incidenza di questa malattia, il suo riscontro ha delle implicazioni terapeutiche e prognostiche importanti in questa special population.…”

Section: Hypertransaminasemia In Hiv-infected Patients Is Most Commonunclassified

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Epatite autoimmune in paziente con infezione da HIV: descrizione di un caso clinico.

Trizzino¹

2020

JHA

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L’ipertransaminasemia nei pazienti con infezione da HIV è più comunemente riconducibile a cause virali, infezioni opportunistiche, steatosi epatica o danno indotto dai farmaci. L'epatite autoimmune (AIH) è riportata in letteratura come evento alquanto raro in questa tipologia di pazienti. L'AIH è caratterizzata dalla presenza di autoanticorpi circolanti, aumento delle gammaglobuline, risposta alla terapia steroidea e da un punto di vista istologico dalla presenza di epatite da interfaccia, infiltrato infiammatorio prevalentemente linfomonocitario e formazione di rosette. La terapia immunosoppressiva appare sicura nei pazienti HIV con AIH. Il nostro caso clinico riguarda un uomo africano di 41 anni, con infezione da HIV nota da diversi anni in terapia antiretrovirale, che clinicamente si presenta con un quadro di dolore addominale, astenia e ipertransaminasemia.

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Section: Discussioneunclassified

Section: Hypertransaminasemia In Hiv-infected Patients Is Most Commonunclassified

Epatite autoimmune in paziente con infezione da HIV: descrizione di un caso clinico.

Trizzino¹

2020

JHA

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Autoantibodies Among HIV-1 Infected Individuals and the Effect of Anti-Retroviral Therapy (ART) on It

Steve

Alex

Yesudhason

et al. 2021

CHR

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Background:: Antiretroviral therapy (ART) has led to a decline in autoimmune diseases but lacks studies on its effect on autoantibodies. Methods: A cross-sectional study with archived samples from 100 paired HIV-1 infected ART naïve and experienced individuals and 100 prospectively collected matched blood-donor controls. Antinuclear antibody, IgG anticardiolipin antibody, IgM and IgG β2 glycoprotein-1 antibodies, and total IgG levels were detected. Results are expressed as mean with standard deviation (SD), median, percentage positivity, and a p<0.05 is considered significant. The study was approved by the Institutional Review Board. Results: The median viral load of the treatment naïve samples was 4.34 Log copies/mL while all were virally suppressed post ART with a median duration of treatment for 12 months (range: 3-36 months). The percentage positivity of antinuclear antibody was 5% among ART naïve and controls with a decrease to 2% post ART (p= 0.441). The positivity for anti-cardiolipin antibody was 15% among ART naïve while none of the ART experienced or controls were positive (p<0.05). IgM β2 glycoprotein-1 was 4%, 1% and 3% among ART naïve, treated and controls respectively (p<0.05). IgG β2 glycoprotein-1 was 2% among ART naïve while none of the treated and controls were positive (p<0.05). The mean total IgG level among ART naïve, experienced, and controls were 21.82 (SD 6.67), 16.91 (SD 3.38), 13.70 (SD 2.24) grams/Litre respectively (p<0.05). Conclusion: ART has a significant effect on IgG anti-cardiolipin antibody and total IgG but only a marginal effect on ANA, IgM, and IgG β2 glycoprotein-1 antibodies.

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Autoimmune Hepatitis in People Living with HIV: A Case Series and Review of Literature

Laurenda,

Anneka,

Giovanni

et al. 2023

TOAIDJ

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Background: Autoimmune immune disorders are rare in people living with human immunodeficiency virus (HIV), especially autoimmune-related liver disease. Additionally, diagnosis is challenging as there can be multiple reasons for abnormal liver tests in people living with HIV. Since autoimmune hepatitis responds well to immunosuppression and delaying treatment can be detrimental, its diagnosis and treatment must not be delayed or missed. To increase awareness amongst clinicians, thus ensuring prompt diagnosis and treatment, we present three patients with autoimmune hepatitis in the context of people living with HIV. Case Presentation: Three individuals aged between 47-63 years (two females and one male) present with significant transaminitis (alanine aminotransferase 5-10 x upper limit of normal), with two out of the three being autoantibody-positive with an elevated IgG. In all three individuals, a liver biopsy was consistent with autoimmune hepatitis and, in addition, showed advanced hepatic fibrosis/cirrhosis. All individuals presented following immune reconstitution. There was a good response to immunosuppression with a reduction in hepatic fibrosis. All are currently in clinical and biochemical remission. Conclusion: Autoimmune hepatitis, though rare, must be considered in the differential diagnosis of abnormal liver tests in people living with human immunodeficiency virus. There should be a low threshold to perform a liver biopsy, which can be diagnostic in the right clinical setting. A prompt institution of immunosuppression is warranted to induce remission and attenuate hepatic fibrosis. However, long-term management and outcomes, including the duration of immunosuppression, remain unclear.

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Autoimmune Hepatitis (AIH) in Acquired Immune Deficiency Syndrome (AIDS): A Case Report and Review of Literature

Cited by 3 publications

References 23 publications

Epatite autoimmune in paziente con infezione da HIV: descrizione di un caso clinico.

Epatite autoimmune in paziente con infezione da HIV: descrizione di un caso clinico.

Autoantibodies Among HIV-1 Infected Individuals and the Effect of Anti-Retroviral Therapy (ART) on It

Autoimmune Hepatitis in People Living with HIV: A Case Series and Review of Literature

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