Acute autoimmune hepatitis diagnosed concurrently with human immunodeficiency virus.
George Lennox, Abed Arnaout, Lisa Hamzah et al.
✦ AI-curated · Sources linked
Case in brief
A woman in her 50s presented with jaundice and severe hepatocellular injury, later diagnosed with advanced HIV infection. Initial considerations included infectious hepatitis, but serology, imaging, and liver biopsy ruled out viral causes. Elevated immunoglobulin G and positive autoantibodies confirmed acute autoimmune hepatitis. She responded well to corticosteroids and transitioned to azathioprine, achieving normal liver function and undetectable HIV viral load.
What made this case unusual
The concurrent diagnosis of acute autoimmune hepatitis in a patient with advanced HIV and profound immunosuppression is exceptionally rare, with few cases reported.
Diagnostic / clinical pearl
Clinicians should consider autoimmune hepatitis in patients with liver dysfunction, even in the context of advanced HIV, where opportunistic infections are typically prioritized.
Why it matters
This case underscores the importance of thorough investigation in atypical presentations of liver dysfunction, which can lead to the identification of treatable conditions.