Covini Giovanni, Bredi Elena, Badalamenti Salvatore, Roncalli Massimo, Aghemo Alessio, Colombo Massimo
Liver Unit and Center for Autoimmune Liver Diseases.
Clinical Investigation Laboratory.
Hepatol Commun. 2018 Sep 25;2(10):1179-1183. doi: 10.1002/hep4.1248. eCollection 2018 Oct.
We report the case of a woman with chronic hepatitis C and idiopathic thrombocytopenic purpura (ITP) who developed autoimmune hepatitis (AIH) during antiviral therapy with ledipasvir (LDV)/sofosbuvir (SOF). The onset of acute hepatitis rose two weeks after starting treatment with LDV/SOF when HCV-RNA tested negative, suggesting a link between rapid HCV clearance and autoimmune diseases. This case report proposes new immunologic scenarios in patients with hepatitis C virus (HCV) with laboratory or clinical signs of autoimmunity during direct-acting antiviral (DAA) therapy.
我们报告了一例患有慢性丙型肝炎和特发性血小板减少性紫癜(ITP)的女性病例,该患者在接受来迪派韦(LDV)/索磷布韦(SOF)抗病毒治疗期间发生了自身免疫性肝炎(AIH)。在用LDV/SOF开始治疗两周后,出现急性肝炎发作,此时HCV-RNA检测为阴性,提示快速清除HCV与自身免疫性疾病之间存在关联。本病例报告提出了在直接抗病毒(DAA)治疗期间,丙型肝炎病毒(HCV)患者出现自身免疫实验室或临床体征的新免疫情况。