Published online May 18, 2016. doi: 10.4254/wjh.v8.i14.632
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
Processing time: 135 Days and 8.5 Hours
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.
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.