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Manrai M, Vashisht R, Arivalagan B, Baveja P, Kashif AW, Menon A. Coexistence of human immunodeficiency virus infection and autoimmune hepatitis: A double trouble. Indian J Sex Transm Dis AIDS 2023; 44:66-68. [PMID: 37457519 PMCID: PMC10343110 DOI: 10.4103/ijstd.ijstd_73_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 07/31/2022] [Accepted: 10/19/2022] [Indexed: 12/13/2022] Open
Abstract
A wide spectrum of hepatobiliary manifestations occur in Human Immunodeficiency Virus (HIV)-infected patients. Among the common causes are the infectious hepatitis, drug-related hepatitis, opportunistic infections, non-alcoholic steatohepatitis, HIV cholangiopathy and neoplasm. Auto-immune hepatitis (AIH) is rarely reported in this setting. We present two different presentations of auto immune hepatitis in HIV positive patients. One developed jaundice and ascites as a consequence of liver decompensation and other exhibited cholestatic pattern. Their serology and liver biopsy confirmed autoimmune hepatitis as underlying aetiology. We would like to share the clinical improvement with simultaneous immunosuppressive therapy and combination Anti Retroviral Therapy (cART). There are no documented cases on this issue from the Indian subcontinent that we are aware of.
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Affiliation(s)
- Manish Manrai
- Department of Internal Medicine, AFMC, Pune, Maharashtra, India
| | - Rohit Vashisht
- Department of Internal Medicine, AFMC, Pune, Maharashtra, India
| | | | - Puneet Baveja
- Department of Pathology, AFMC, Pune, Maharashtra, India
| | | | - Anil Menon
- Department of Internal Medicine, AFMC, Pune, Maharashtra, India
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Lad SG, Kolhe K, Chauhan S, Gattani M, Sethiya P, Singh GK, Kiran B, Ingle M, Pandey V. AIH in HIV: A Very Much Possible Entity. J Clin Exp Hepatol 2022; 12:1388-1392. [PMID: 36157146 PMCID: PMC9499873 DOI: 10.1016/j.jceh.2022.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 05/09/2022] [Indexed: 12/12/2022] Open
Abstract
Autoimmune Hepatitis (AIH) is a chronic liver disease Characterized by interface hepatitis, lymphoplasmacytic infiltrate, and hepatic rosettes. HIV infection is a state of immunosuppression; hence, the possibility of AIH is relatively rare, especially in patients with low CD4 counts. Therefore, we present an interesting case series of four patients with autoimmune liver disease with myriad presentations for the first time from India. We propose that despite the rarity of this presentation with immunosuppression, one should never miss such a treatable cause of liver disease leading to good clinical outcomes.
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Key Words
- ACLF, Acute on chronic liver failure
- AIH, Autoimmune Hepatitis
- AKI, Acute kidney injury
- ALT, Alanine transaminase
- ANA, Antinuclear antibody
- ART, Antiretroviral therapy
- ASMA, Anti smooth muscle antibody
- AST, Aspartate aminotransferase
- CAM, Complementary and alternative medications
- DILI, Drug-induced liver injury
- GGT, Gamma-transferase
- HAV, Hepatitis A Virus
- HEV, Hepatitis E Virus
- HIV, Human immunodeficiency Virus
- IRIS, Immune reconstitution inflammatory syndrome
- LFT, Liver function test
- PHG, portal hypertensive gastropathy
- TJLB, Transjugular liver biopsy
- autoimmune hepatitis (AIH)
- cART, Combination antiretroviral therapy
- drug-induced liver injury – AIH (DILI-AIH)
- human immunodeficiency virus (HIV)
- iAIH, Denovo Idiopathic AIH
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Affiliation(s)
- Saiprasad G. Lad
- Dept of Gastroenterology, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai- 400022, India
| | - Kailash Kolhe
- Dept of Gastroenterology, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai- 400022, India
| | - Shamshersingh Chauhan
- Dept of Gastroenterology, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai- 400022, India
| | - Mayur Gattani
- Dept of Gastroenterology, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai- 400022, India
| | - Pratik Sethiya
- Dept of Gastroenterology, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai- 400022, India
| | - Gaurav K. Singh
- Dept of Gastroenterology, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai- 400022, India
| | - B. Kiran
- Dept of Gastroenterology, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai- 400022, India
| | - Meghraj Ingle
- Dept of Gastroenterology, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai- 400022, India
| | - Vikas Pandey
- Dept of Gastroenterology, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai- 400022, India
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Ugarte A, De la Mora L, Martínez-Rebollar M, Mallolas J, Laguno M. An unexpected adverse effect: Elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide–induced cholestasis. Antivir Ther 2021; 26:9-12. [DOI: 10.1177/13596535211045832] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- Ainoa Ugarte
- Infectious Diseases Department, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Lorena De la Mora
- Infectious Diseases Department, Hospital Clinic of Barcelona, Barcelona, Spain
| | | | - Josep Mallolas
- Infectious Diseases Department, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Montserrat Laguno
- Infectious Diseases Department, Hospital Clinic of Barcelona, Barcelona, Spain
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