Autoimmune hepatitis in the course of chronic HAV--four year observation

The paper presents a case of a 17-year-old girl with type 1 autoimmune hepatitis in whom biochemical, serological and histopathological markers of chronic hepatitis A were observed for the last 4 years. The diagnosis was based on elevated levels of gammaglobulins, IgG and the presence of autoantibodies (ANA, SMA). At first, the patient was treated with the pulses of corticosteroids and then, as no improvement was observed, continuous steroid therapy was involved. Relatively mild clinical course of the disease and good response to treatment with prednisone were recorded. Our observations suggest that HAV is capable of inducing autoimmune reactions and they indicate possible development of chronic hepatitis A.