Autoimmune hepatitis in a patient infected by HIV-1 and under highly active antiretroviral treatment:Case report and literature review

作     者：Marta Casal Moura Edite Pereira Vítor Braz Catarina Eloy Joanne Lopes Fátima Carneiro José Paulo Araújo 

作者机构：Faculdade de Medicina da Universidade do Porto4200-319 PortoPortugal Servico de Medicina InternaCentro Hospitalar de Sao Joao4200-319 PortoPortugal Serviao de Anatomia PatológicaCentro Hospitalar de Sao Joao4200-319 PortoPortugal 

出 版 物：《World Journal of Immunology》 (世界免疫学杂志)

年 卷 期：2014年第4卷第3期

页      面：194-198页

学科分类：12[管理学] 1204[管理学-公共管理] 120402[管理学-社会医学与卫生事业管理(可授管理学、医学学位)] 1004[医学-公共卫生与预防医学(可授医学、理学学位)] 10[医学] 

主　　题：Autoimmune hepatitis Human immunode-fciency virus type 1 Highly active antiretroviral treat-ment Liver tests Liver biopsy 

摘      要：Liver disease has recently been described as an im-portant cause of morbidity and mortality in patientsinfected with human immunodeficiency virus （HIV）.Liver test changes are useful surrogates of the burdenof liver disease. Previous studies have shown that trans-aminase elevations are frequent among these *** cause of those changes is harder to establish inHIV-patients. We present a 61-year-old caucasian male,diagnosed with HIV type 1 infection since 1998, underhighly active antiretroviral treatment （HAART）, withvirological suppression and immunological *** presented in a follow-up laboratory workup highvalues of transaminases, arthralgia at the hip joints and hepatomegaly. Liver function tests were normal. Theantibodies to hepatitis viruses were negative. However,autoimmune study and liver biopsy were compatible with autoimmune hepatitis （AIH）. The AIH is a rare di-agnosis in HIV-infected patients perhaps because the elevation of transaminases and changes in liver function tests are often associated to HAART or to other possible liver diseases, namely viral hepatitis and non-alcoholic steatohepatitis. The diagnosis may be underestimated. There are no specifc recommendations available for the treatment of HIV-associated AIH although the immuno-supression with slower tapering seems the most reason-able approach.