Development of Autoimmune Hepatitis during Direct-acting Antiviral Therapy for Chronic Hepatitis C Virus Infection

Kotaro Matsumoto; Kentaro Kikuchi; Yusuke Kajiyama; Yuichi Takano; Masatoshi Mabuchi; Shinpei Doi; Koichiro Sato; Hiroshi Miyakawa; Ichiro Yasuda

doi:10.2169/internalmedicine.0613-17

CASE REPORTS

Development of Autoimmune Hepatitis during Direct-acting Antiviral Therapy for Chronic Hepatitis C Virus Infection

Kotaro Matsumoto, Kentaro Kikuchi, Yusuke Kajiyama, Yuichi Takano, Masatoshi Mabuchi, Shinpei Doi, Koichiro Sato, Hiroshi Miyakawa, Ichiro Yasuda

Author information

Kotaro Matsumoto
Department of Gastroenterology, Teikyo University Mizonokuchi Hospital, Japan
Kentaro Kikuchi
Fourth Department of Internal Medicine, Teikyo University Mizonokuchi Hospital, Japan
Yusuke Kajiyama
Department of Gastroenterology, Teikyo University Mizonokuchi Hospital, Japan
Yuichi Takano
Department of Gastroenterology, Teikyo University Mizonokuchi Hospital, Japan
Masatoshi Mabuchi
Department of Gastroenterology, Teikyo University Mizonokuchi Hospital, Japan
Shinpei Doi
Department of Gastroenterology, Teikyo University Mizonokuchi Hospital, Japan
Koichiro Sato
Department of Gastroenterology, Teikyo University Mizonokuchi Hospital, Japan
Hiroshi Miyakawa
Fourth Department of Internal Medicine, Teikyo University Mizonokuchi Hospital, Japan
Ichiro Yasuda
Department of Gastroenterology, Teikyo University Mizonokuchi Hospital, Japan

Keywords: autoimmune hepatitis, direct-acting antivirals, chronic hepatitis C virus infection, prednisolone

JOURNAL OPEN ACCESS

2018 Volume 57 Issue 18 Pages 2669-2673

DOI https://doi.org/10.2169/internalmedicine.0613-17

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Details

Abstract

An 81-year-old woman developed liver dysfunction after two months' treatment with direct-acting antivirals (DAAs) for chronic hepatitis C virus (HCV) infection. She was positive for serum anti-nuclear antibody, with an elevated immunoglobulin G level. A liver biopsy revealed high-grade interface hepatitis and infiltrate of lymphocytes and plasma cells. DAA-associated drug-induced autoimmune hepatitis (DI-AIH) was considered. Her liver dysfunction improved after discontinuing DAA therapy and starting prednisolone treatment. The differential diagnosis for AIH should include liver injury during DAA therapy for chronic HCV infection.

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