Autoimmune hepatitis in human immunodeficiency virus infection: Case report and literature review

Table 1 Simplified diagnostic criteria for autoimmune hepatitis, adapted from EASL Clinical Practice Guidelines: Autoimmune hepatitis, 2015

Parameter	Discriminator	Score
ANA or ASMA+	≥ 1:40	1
ANA or ASMA+	≥ 1:80	2
ANA or LKM+	≥ 1:40	2
ANA or SLA/LP+	Any title	2
IgG or gamma globulins	> ULN	1
	> 1.1 × ULN	2
Liver biopsy	Compatible with AIH	1
	Typical AIH	2
	Atypical	0
Absence of viral hepatitis	No	0
	Yes	2

Definitive autoimmune hepatitis ≥ 7; probable autoimmune hepatitis ≥ 6. Typical liver biopsy for autoimmune hepatitis: Each one of the following characteristics must be present: Interface hepatitis, lymphocytic/lymphoplasmacytic infiltrates in the portal tracts, and extending toward the lobes, emperipolesis (active penetration by a cell within another cell), hepatocyte rosettes formations. Liver biopsy consistent with autoimmune hepatitis: Chronic hepatitis with lymphoplasmacytic infiltrate without all the characteristics considered typical. Atypical liver biopsy: Signs of another diagnosis. ANA: Anti-nuclear antibodies; ASMA: Anti-smooth muscle antibodies; LKM: Liver kidney microsomal antibodies; SLA/LP: Antibodies to soluble liver antigen/pancreas; IgG: Immunoglobulin G; ULN: Upper limit of normal; AIH: Autoimmune hepatitis.