Regular PaperInterferon therapy in liver/kidney microsomal antibody type 1-positive patients with chronic hepatitis C
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The clinical usage and definition of autoantibodies in immune-mediated liver disease: A comprehensive overview
2018, Journal of AutoimmunityCitation Excerpt :In this context, exposure to HCV and Herpes viruses may lead to type 2 AIH in genetically predisposed patients [111,112]. Anti-LKM1-positive HCV-infected patients were a challenging clinical problem in the interferon treatment era, since interferon may trigger autoimmunity [113], but this is no longer the case in the direct-antiviral agents era, where HCV infection can be effectively and safely cured [21]. Lastly, anti-LKM1 has been detected in patients suffering from hepatitis in the context of autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED), a rare autosomal recessive disorder linked to homozygous mutations in the autoimmune regulator gene (AIRE).
Clinical and prognostic implications of acute onset of Autoimmune Hepatitis: An Italian multicentre study
2018, Digestive and Liver DiseaseCitation Excerpt :In particular the acute presentation of AIH may contain two different clinical entities, one is the acute exacerbation of chronic AIH and the other is the genuine acute AIH without chronic histological changes [10–12]. On the other hand, autoimmune flares driven by immuno-modulatory therapies such as interferon for hepatitis C [13–16], are no longer observed, thanks to the implementation of HCV-specific direct acting antiviral molecules [17]. A very small number of AIH can present with a severe/fulminant onset, with early encephalopathy and coagulopathy, development of acute hepatic failure and the urgent need for liver transplantation [18–21].
EASL clinical practice guidelines: Autoimmune hepatitis
2015, Journal of HepatologyInterferon beta 1a-induced severe autoimmune hepatitis in patients with multiple sclerosis: Report of two cases and review of the literature
2015, Annals of HepatologyCitation Excerpt :Yet, it has been observed that IFN alpha may induce hepatic decompensation and liver failure, especially in cirrhotic patients with chronic hepatitis B or C.8–10 Possible explanations have been related to exacerbations by IFN of immune mediated lysis of virus-infected hepatocytes,10 direct cytotoxic effect8 or induction of autoimmune events.11,12 It has also been observed the development and/or exacerbation5,13 of AIH in association with IFN alfa treatment for hepatitis C, a viral infection that per se has been related with autoimmunity.14 –16
Autoimmune hepatitis in patients with chronic HBV and HCV infections: Patterns of clinical characteristics, disease progression and outcome
2014, Annals of HepatologyCitation Excerpt :Of relevance, viral infections can operate as triggers for the development of autoimmunity. HCV infection in particular has been implicated in the activation of latent AIH either by the virus itself or through IFN-alpha.5,7,12,13,17 However, in real life it is often difficult to distinguish between these scenarios (Table 2).