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Abstract
Liver disease in HIV-infected patients is complex and multifactorial. Drug toxicity and infections are common causes of elevations in liver-associated enzymes. Immune reconstitution and unmasking of autoimmune disease may also play a role, particularly in the era of effective combination antiretroviral therapy. In this case report, we describe the first reported biopsy-confirmed case of autoimmune hepatitis and primary biliary cirrhosis overlap syndrome presenting in an HIV-infected patient following initiation of antiretroviral therapy.
Highlights
The term “overlap syndrome” describes the rare interface between autoimmune hepatitis (AIH) and primary biliary cirrhosis (PBC) or primary sclerosing cholangitis (PSC)
Dilution) and the Ventana Ultra View detection system. Based on this histology and supporting laboratory findings of hypergammaglobulinemia, positive anti-nuclear and antimitochondrial antibodies, the patient was diagnosed with primary biliary cirrhosis and autoimmune hepatitis overlap syndrome
We present the first biopsy-confirmed case of a patient with Human Immunodeficiency Virus (HIV) infection and overlapping AIH and PBC in the setting of antiretroviral therapy and immune reconstitution
Summary
The term “overlap syndrome” describes the rare interface between autoimmune hepatitis (AIH) and primary biliary cirrhosis (PBC) or primary sclerosing cholangitis (PSC). Diagnostic criteria and treatment for this spectrum of autoimmune liver disease remain controversial [1]. Co-existence of Human Immunodeficiency Virus (HIV) infection further complicates diagnosis and treatment in patients with abnormal liver associated enzymes (LAEs).
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