Autoimmune hepatitis in a patient infected by HIV-1 and under highly active antiretroviral treatment: Case report and literature review

Table 1 Features supporting the diagnosis of autoimmune hepatitis

Parameters	Diagnosis of autoimmune hepatitis
Clinical	Female gender
	Association with other autoimmune diseases
Autoantibodies	ANA or SMA > 1:40 (type 1)
	LKM > 1:40 (type 2)
	SLA + (type 3)
Immunoglobulin	IgG > upper normal limit
Biochemistry	Hepatitic pattern (raised AST and ALT levels)
Histology	Plasma cell-rich mononuclear infiltrate
	Interface hepatitis with ballooning and rosetting of peri-portal hepatocyte; ± peri-portal fibrosis
	Lobular necroinflammatory activity
	No bile duct loss or chronic cholestasis
Radiology and ERCP	Normal
Exclusion of other etiology	Exclusion of viral, metabolic, drug and alcoholic etiology
Response to steroid	Good

ALT: Alanine aminotransferase; ANA: Antinuclear antibodies; AST: Aspartate aminotransferase; IgG: Immunoglobulin G; LKM: Liver kidney microsome antibodies; SLA: Soluble liver antigen antibodies; SMA: Smooth muscle antibodies.

Table 2 Laboratory workup results

Auto-immunity	11.2009	Reference values
ANA	> 1/1000 nucleolar	< 1/100
SMA	Slightly positive	Negative
Copper Metabolism
Copper (mcg/dL)	92	50-140
Ceruloplasmin (mg/dL)	24.6	18-45
Iron Metabolism
Iron (mcg/dL)	274	53-167
Transferrin (mg/dL)	233	206-360
Ferritin (ng/mL)	1274.8	16.4-293.9
Transferrin Saturation (%)	84	15-50 (males)
Lipid Profile
Total cholesterol (mg/dL)	140	< 200
LDL cholesterol (mg/dL)	83	< 130
HDL cholesterol (mg/dL)	41	> 40
Triglycerides (mg/dL)	69	< 150

ANA: Antinuclear antibodies; HDL: High density lipoprotein; LDL: Low density lipoprotein; SMA: Smooth muscle antibodies.