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 ...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 patients.The 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 recovery.He 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.展开更多
文摘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 patients.The 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 recovery.He 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.
