Healing of autoimmune hepatitis associated with hepatitis C virus infection treated with direct-acting antivirals

Couceiro, Laura López; Domínguez, Elena Gómez; Gómez, R.; Tortajada, G Castellano; Andrés, Carolina Ibarrola de; Vázquez, Inmaculada Fernández

doi:10.17235/reed.2018.5528/2018

Cited by 6 publications

(4 citation statements)

References 8 publications

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“…Слабость, артралгия АИГ [11][12][13]. Вместе с тем описаны случаи дебюта АИГистинного и лекарственно-индуцированного -во время и после лечения препаратами прямого действия [14][15][16].…”

Section: рис 2 п 1985 гр хронический гепатит с Hcv рнк 1bunclassified

“…Периодически появлялись сообщения о развитии АИГ de novo или о его обострении в процессе или после интерферонотерапии[10,11], в связи с чем логичным выбором являлся предварительный курс иммуносупрессоров, что и было предпринято в нашем наблюдении. Внедрение в клиническую практику препаратов прямого противовирусного действия позволило успешно излечивать большинство больных с перекрестным синдромом ХГС/…”

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Cross-syndrome of Chronic Hepatitis C and Type 1 Autoimmune Hepatitis with Subsequent Transformation into Type 2 Autoimmune Hepatitis: a Clinical Case

Buyeverov¹,

Roschina²,

Kuzmina³

et al. 2022

EPh

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We present clinical case of patient with initially diagnosed chronic hepatitis C with an autoimmune component corresponding to type 1 autoimmune hepatitis. Considering that at the time of diagnosis, the therapeutic possibilities of hepatitis C were limited to the use of standard or pegylated interferon α in combination with ribavirin, in order to avoid the adverse immunomodulatory effect of interferon, we previously suppressed the autoimmune component with immunosuppressors. After 6-month course of prednisolone and azathioprine, antiviral therapy with interferon α and ribavirin was carried out with the achievement of sustained virological and biochemical response. After 7 years of complete virological, immunological and biochemical remission, the patient manifested autoimmune hepatitis type 2. The appointment of prednisolone and azathioprine led to a stable drug-induced remission.

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Section: рис 2 п 1985 гр хронический гепатит с Hcv рнк 1bunclassified

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Cross-syndrome of Chronic Hepatitis C and Type 1 Autoimmune Hepatitis with Subsequent Transformation into Type 2 Autoimmune Hepatitis: a Clinical Case

Buyeverov¹,

Roschina²,

Kuzmina³

et al. 2022

EPh

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“…HCV biomarkers are also rarely detected in AIH[ 89 ]. However, AIH was successfully treated with DAA in a patient with concomitant HCV infection[ 90 ].…”

Section: Hepatitis Cmentioning

confidence: 99%

Immune disorders and rheumatologic manifestations of viral hepatitis

Maslennikov¹,

Ивашкин²,

Efremova³

et al. 2021

WJG

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Infection with hepatotropic viruses is not limited to the liver and can lead to the development of various immunological disorders (the formation of cryoglobulins, rheumatoid factor, antinuclear antibodies, autoantibodies specific for autoimmune hepatitis and primary biliary cholangitis, and others), which can manifest as glomerulonephritis, arthritis, uveitis, vasculitis (cryoglobulinemic vasculitis, polyarteritis nodosa, Henoch-Schonlein purpura, isolated cutaneous necrotizing vasculitis), and other rheumatologic disorders, and be a trigger for the subsequent development of autoimmune hepatitis and primary biliary cholangitis. A further study of the association between autoimmune liver diseases and hepatotropic virus infection would be useful to assess the results of treatment of these associated diseases with antiviral drugs. The relationship of these immune disorders and their manifestations with hepatotropic viruses is best studied for chronic hepatitis B and C. Only isolated cases of these associations are described for hepatitis A. These links are least studied, and are often controversial for hepatitis E, possibly due to their relatively rare diagnoses. Patients with uveitis, glomerulonephritis, arthritis, vasculitis, autoimmune liver diseases should be tested for biomarkers of viral hepatitis, and if present, these patients should be treated with antiviral drugs.

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“…In these cases the patients are positive for HCV but also have autoantibodies. After successful treatment for the virus the patients show characteristic clinical and histologic features of AIH (27,28). Drug induced liver injury may mimic AIH (29), especially with drugs such as minocycline, alpha methyldopa, nitrofurantoin and checkpoint inhibitors such as infliximab when taken for longer periods of time.…”

Section: Differential Diagnosismentioning

confidence: 99%

Autoimmune hepatitis—is histology conclusive?

Beer¹,

Dienes²

2021

Ann Transl Med

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Liver biopsy is an essential and necessary element in the diagnosis and management of autoimmune hepatitis, and is of very special importance in the scoring system for diagnosis. Histopathology shows moderate to severe inflammatory infiltrates with abundant plasma cells in the enlarged portal tracts with interface hepatitis and moderate to severe necroinflammatory lesions in the lobules with lymphoplasmacytic reaction. Regeneration develops with rosette formation and regenerative nodules. One important issue is the differentiation between acute onset of autoimmune hepatitis and a flare up of chronic disease; this cannot be diagnosed in some cases clinically and therefore requires a biopsy to evaluate the stage of the disease. There are some variants of the disease with cholestatic features such as autoantibody negative autoimmune hepatitis and giant cell hepatitis as well as overlap syndromes with primary biliary cholangitis and primary sclerosing cholangitis. Clinically, three types of autoimmune hepatitis are differentiated according to autoantibody formation and the clinical picture, however, histopathologically there is no difference between these three types. Differential diagnosis of autoimmune hepatitis includes drug-induced liver injury with minocycline, alpha methyldopa, nitrofurantoin and checkpoint inhibitors such as infliximab.Wilson´s disease is also an important differential diagnosis especially in young adults. A liver biopsy is mandatory to confirm the diagnosis of autoimmune hepatitis but histopathology alone is not conclusive.

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Healing of autoimmune hepatitis associated with hepatitis C virus infection treated with direct-acting antivirals

Cited by 6 publications

References 8 publications

Cross-syndrome of Chronic Hepatitis C and Type 1 Autoimmune Hepatitis with Subsequent Transformation into Type 2 Autoimmune Hepatitis: a Clinical Case

Cross-syndrome of Chronic Hepatitis C and Type 1 Autoimmune Hepatitis with Subsequent Transformation into Type 2 Autoimmune Hepatitis: a Clinical Case

Immune disorders and rheumatologic manifestations of viral hepatitis

Autoimmune hepatitis—is histology conclusive?

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