Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Sep 21, 2019; 25(35): 5388-5402
Published online Sep 21, 2019. doi: 10.3748/wjg.v25.i35.5388
Autoimmune hepatitis in human immunodeficiency virus-infected patients: A case series and review of the literature
Roongruedee Chaiteerakij, Anapat Sanpawat, Anchalee Avihingsanon, Sombat Treeprasertsuk
Roongruedee Chaiteerakij, Sombat Treeprasertsuk, Department of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok 10330, Thailand
Anapat Sanpawat, Department of Pathology, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok 10330, Thailand
Anchalee Avihingsanon, Medical Department, The HIV Netherlands Australia Thailand Research Collaboration, Bangkok 10330, Thailand
Author contributions: Chaiteerakij R was the patients’ hepatologist, reviewed the literature and contributed to manuscript drafting; Sanpawat A performed the pathological diagnosis and contributed to manuscript drafting; Avihingsanon A performed the HIV disease consultation and contributed to manuscript drafting; Treeprasertsuk S were the patients’ hepatologist, reviewed the literature and contributed to manuscript drafting. Chaiteerakij R and Treeprasertsuk S were responsible for the revision of the manuscript for important intellectual content; all authors issued final approval for the version to be submitted.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Sombat Treeprasertsuk, MD, PhD, Professor of Internal Medicine, Division of Gastroenterology, Department of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, 1873 Rama IV Road, Patumwan, Bangkok 10330, Thailand. apobtsol@hotmail.com.
Telephone: +66-2-2564265 Fax: +66-2-6524129
Received: June 22, 2019
Peer-review started: June 25, 2019
First decision: July 22, 2019
Revised: August 14, 2019
Accepted: August 24, 2019
Article in press: July 22, 2019
Published online: September 21, 2019
Core Tip

Core tip: Elevated liver enzymes are a common problem in human immunodeficiency virus (HIV)-infected patients. Clinical manifestations of autoimmune hepatitis (AIH) range from no symptoms to mild chronic hepatitis to acute severe hepatitis leading to fulminant hepatic failure or cirrhosis. The diagnosis of AIH requires thorough investigation. It is crucial to perform liver biopsy to confirm the diagnosis. Although rare, AIH should be considered a differential diagnosis in HIV-infected patients presenting with elevated aminotransferase enzyme levels after the exclusion of other common causes of hepatitis. It is believed that this condition occurs due to immune reconstitution inflammatory syndrome (IRIS). Immunosuppressive drugs are the mainstay of treatment and can be used safely in HIV-infected patients.