Is autoimmune hepatitis a frequent finding among HCV patients with intense interface hepatitis?

Badiani, Rosilene G.; Perez, Renata M.; Matos, Carla; Lemos, Lara B.; Lanzoni, Valéria Pereira; Andrade, Luís Eduardo Coelho; Dellavance, Alessandra; Silva, Antonio Eduardo B.; Ferraz, Maria Lúcia Gomes

doi:10.3748/wjg.v16.i29.3704

Cited by 18 publications

(16 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Whether intense interface hepatitis in HCV infected patients is caused by concurrent AIH was retrospectively studied [90]. In 92 patients with HCV infection, only 2% of biopsies had intense interface hepatitis and other histological findings typical of AIH.…”

Section: Concomitant Autoimmune Hepatitis and Other Chronic Liver Dismentioning

confidence: 99%

Autoimmune hepatitis

Sahebjam

Vierling

2015

Front. Med.

View full text Add to dashboard Cite

Autoimmune hepatitis is a chronic liver disease putatively caused by loss of tolerance to hepatocyte-specific autoantigens. It is characterized by female predilection, elevated aminotransferase levels, autoantibodies, increased γ-globulin or IgG levels and biopsy evidence of interface hepatitis. It is currently divided into types 1 and 2, based on expression of autoantibodies. Autoantigenic epitopes have been identified only for the less frequent type 2. Although autoimmune hepatitis occurs in childhood, this review focuses on disease in adults. In the absence of pathognomonic biomarkers, diagnosis requires consideration of clinical, biochemical, serological and histological features, which have been codified into validated diagnostic scoring systems. Since many features also occur in other chronic liver diseases, these scoring systems aid evaluation of the differential diagnosis. New practice guidelines have redefined criteria for remission to include complete biochemical and histological normalization on immunosuppressive therapy. Immunosuppression is most often successful using prednisone or prednisolone and azathioprine; however, the combination of budesonide and azathioprine for non-cirrhotic patients offers distinct advantages. Patients failing standard immunosuppression are candidates for alternative immunosuppressive regimens, yet none of the options has been studied in a randomized, controlled trial. Overlap syndromes with either primary sclerosing cholangitis or primary biliary cirrhosis occur in a minority. Liver transplantation represents a life-saving option for patients presenting with acute liver failure, severely decompensated cirrhosis or hepatocellular carcinoma. Transplant recipients are at risk for recurrent autoimmune hepatitis in the allograft, and de novo disease may occur in patients transplanted for other indications. Patients transplanted for AIH are also at risk for recurrent or de novo inflammatory bowel disease. Progress in our understanding of the immunopathogenesis should lead to identification of specific diagnostic and prognostic biomarkers and new therapeutic strategies.

show abstract

Section: Concomitant Autoimmune Hepatitis and Other Chronic Liver Dismentioning

confidence: 99%

Autoimmune hepatitis

Sahebjam

Vierling

2015

Front. Med.

View full text Add to dashboard Cite

show abstract

“…However, other positions of the simplified IAIHG scoring system were not fulfilled: the median gammaglobulin level was not different from the other hepatitis C patients, and only a very small fraction of the 92 patients with interface hepatitis carried SMA or LKM antibodies. Although approximately 12% of all patients generated ANA there was no correlation with interface hepatitis, and application of the simplified IAIHG scoring system revealed only one single case of definite AIH . Thus, rather than proving that HCV infection might lead to AIH, the study demonstrates that interface hepatitis is a histological pattern that is present in some patients with hepatitis C.…”

Section: Hepatitis Virusesmentioning

confidence: 72%

Pathogens and autoimmune hepatitis

Christen

Hintermann

2018

Clinical and Experimental Immunology

View full text Add to dashboard Cite

Autoimmune hepatitis (AIH) is a severe form of hepatitis resulting in the autoimmune-mediated destruction of the liver parenchyma. Whereas many of the immunopathogenic events have been elucidated and some of the drivers of the disease have been identified, little is known about the aetiology of the disease. There are certain risk factors, such as particular human leucocyte antigen (HLA) haplotypes, that enhance the susceptibility for AIH or influence the severity of the disease. However, as for many other autoimmune diseases, the mere presence of such risk factors does not warrant the occurrence of the disease. Not all individuals carrying risk factors develop AIH, and not all patients with AIH are carriers of high-risk alleles. Thus, additional environmental factors need to be considered as triggers for AIH. Environmental factors include diet, sunlight exposure, stress, medication and hygiene, as well as pathogen infections and vaccinations. This review discusses if pathogens should be considered as triggers for the initiation and/or propagation of AIH.

show abstract

“…SMA and ANA, which are characteristic for AIH-1, have been found in up to 66% and 41% of HCV patients, respectively [43]. Recently, a large study was conducted in Brazil with the goal to assess the frequency of AIH in patients with chronic HCV-infection [44]. The authors analyzed liver biopsies from 1759 chronic hepatitis C patients and found intense interface hepatitis compatible with AIH in biopsies of 92 patients.…”

Section: Hepatitis Virusesmentioning

confidence: 98%

“…In contrast, ANA were found more frequently (∼12% of HCV-infected patients), but there was no correlation with the presence of intense interface hepatitis. Finally, following the scoring system of the IAIHG [22] only one patient was classified for definite AIH [44]. This study indicates that interface hepatitis might, although uncommon, also constitute a histological pattern in some patients with hepatitis C.…”

Section: Hepatitis Virusesmentioning

confidence: 99%

Pathogen Infection as a Possible Cause for Autoimmune Hepatitis

Christen

Hintermann

2014

International Reviews of Immunology

View full text Add to dashboard Cite

Autoimmune disorders afflicting the liver comprise the bona fide autoimmune diseases, primary biliary cirrhosis, primary sclerosing cholangitis, and autoimmune hepatitis as well as drug-induced autoimmune-like diseases, such as halothane hepatitis. Whereas drug-induced forms of acute or chronic hepatitis often have a clear triggering factor, the etiology of classical autoimmune liver diseases is only poorly understood. Besides a genetic component present in disease susceptible individuals, environmental triggering factors are likely to play a role in the initiation and/or propagation of the disease. In this article, we will review on current evidence obtained from epidemiological associations, case studies, and findings in animal models for pathogens, to be involved in the etiology of autoimmune liver disease with a special focus on autoimmune hepatitis.

show abstract

Is autoimmune hepatitis a frequent finding among HCV patients with intense interface hepatitis?

Abstract: Although possible, overlap with autoimmune hepatitis is a very rare association in HCV-infected patients with intense interface hepatitis, an unusual presentation which seems to be related to other host variables.

Cited by 18 publications

References 31 publications

Autoimmune hepatitis

Autoimmune hepatitis

Pathogens and autoimmune hepatitis

Pathogen Infection as a Possible Cause for Autoimmune Hepatitis

Contact Info

Product

Resources

About