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[一名HIV-HCV合并感染患者的自身免疫性肝炎:诊断与治疗难题]

[Autoimmune hepatitis in a HIV-HCV co-infected patient: diagnostic ant therapeutic difficulties].

作者信息

Cazanave C, Rakotondravelo S, Morlat P, Blanco P, Bonnet F, Beylot J

机构信息

Service de Médecine Interne et Maladies Infectieuses, Hôpital Saint-André, 1, rue Jean-Burguet, CHU de Bordeaux, 33075 Bordeaux cedex, France.

出版信息

Rev Med Interne. 2006 May;27(5):414-9. doi: 10.1016/j.revmed.2006.01.016. Epub 2006 Mar 3.

Abstract

INTRODUCTION

Autoimmune hepatitis (AIH) is a chronic inflammatory hepatic disorder, characterized by hypergammaglobulinemia and autoantibodies. In some cases, AIH can be associated with another liver disease; such as the hepatitis C-AIH overlap syndrome, which diagnosis and treatment may be delicate.

EXEGESE

We report a type 1 AIH case in a HIV-HCV co-infected woman. AIH remission and HCV eradication were obtained with prednisone and interferon plus ribavirine. AIH relapse appeared with corticosteroid withdrawal and a new remission was obtained with immunosuppressive treatment associating prednisone and azathioprine, without opportunistic infection.

CONCLUSION

This case illustrates diagnostic and therapeutic difficulties of hepatitis C-AIH overlap syndromes in an HIV-infected patient. To our knowledge, it is the first AIH case report in a HIV-HCV co-infected patient.

摘要

引言

自身免疫性肝炎(AIH)是一种慢性炎症性肝脏疾病,其特征为高球蛋白血症和自身抗体。在某些情况下,AIH可与另一种肝脏疾病相关;例如丙型肝炎 - AIH重叠综合征,其诊断和治疗可能较为棘手。

病例报告

我们报告了一名HIV - HCV合并感染女性的1型AIH病例。使用泼尼松、干扰素加利巴韦林实现了AIH缓解和HCV根除。停用皮质类固醇后出现AIH复发,联合使用泼尼松和硫唑嘌呤的免疫抑制治疗获得了新的缓解,且未发生机会性感染。

结论

该病例说明了HIV感染患者中丙型肝炎 - AIH重叠综合征的诊断和治疗困难。据我们所知,这是HIV - HCV合并感染患者中首例AIH病例报告。

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