Case Report
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. May 18, 2016; 8(14): 632-636
Published online May 18, 2016. doi: 10.4254/wjh.v8.i14.632
Direct acting antiviral therapy is curative for chronic hepatitis C/autoimmune hepatitis overlap syndrome
Farhad Sahebjam, Cristina H Hajdu, Esther Nortey, Samuel H Sigal
Farhad Sahebjam, Esther Nortey, Samuel H Sigal, Division of Gastroenterology, New York University School of Medicine, New York, NY 10016, United States
Cristina H Hajdu, Department of Pathology, New York University School of Medicine, New York, NY 10016, United States
Samuel H Sigal, Division of Gastroenterology and Liver Diseases, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY 10467, United States
Author contributions: Sahebjam F and Sigal SH designed the report; Hajdu CH performed pathologic analysis; Nortey E acquired clinical data.
Institutional review board statement: This case report was exempt from the Institutional Review Board standards at the New York University School of Medicine.
Informed consent statement: The patients involved in this case report gave verbal informed consent to be included. Written informed consent was exempt from the Institutional Review Board standards at the New York University School of Medicine.
Conflict-of-interest statement: Samuel H Sigal received research support from AbbVie and Gilead, consulting fees from AbbVie and Gilead, and was a member of the Gilead Speakers’ Bureau. The other authors have no conflicts of interest to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Samuel H Sigal, MD, Division of Gastroenterology and Liver Diseases, Montefiore Medical Center and Albert Einstein College of Medicine, 111 210th Street, Rosenthal 2, Bronx, NY 10467, United States. ssigal@montefiore.org
Telephone: +1-718-9206240 Fax: +1-917-3988466
Received: December 29, 2015
Peer-review started: January 1, 2016
First decision: February 2, 2016
Revised: February 19, 2016
Accepted: March 9, 2016
Article in press: March 14, 2016
Published online: May 18, 2016
Abstract

Autoimmune phenomena are common in patients with chronic hepatitis C. Management of chronic hepatitis C/autoimmune hepatitis syndrome has until recently been problematic due to the adverse effects of interferon on autoimmune processes and immunosuppression on viral replication. In this report we describe 3 patients with chronic hepatitis C/autoimmune hepatitis overlap syndrome who responded rapidly to direct acting anti-viral therapy. The resolution of the autoimmune process supports a direct viral role in its pathophysiology.

Keywords: Hepatitis C, Autoimmune hepatitis, Overlap syndrome, Direct acting antiviral therapy

Core tip: Autoimmune phenomena are common in patients with chronic hepatitis C, and occasionally patients with chronic hepatitis C have concomitant features of autoimmune hepatitis (AIH). Management of these patients has until recently been problematic due to the adverse effects of interferon on autoimmune processes and immunosuppression on viral replication. In this report we describe 3 patients with chronic hepatitis C/AIH overlap syndrome who responded rapidly to direct acting anti-viral therapy with prompt normalization of liver tests and progressive decrease in the serologic markers of AIH. The resolution of the autoimmune process supports a direct viral role in its pathophysiology.