Daas et al. Journal of Medical Case Reports 2011, 5:233 http://www.jmedicalcasereports.com/content/5/1/233 Consent Written informed consent was obtained from the patient for publication of this case report and any accompany- ing images. A copy of the written consent is available for review by the Editor-in-Chief of this journal. Abbreviations AIH: autoimmune hepatitis; HAART: highly active anti-retroviral therapy; HIV: human immunodeficiency virus; VL: viral load. Author details 1Department of Internal Medicine, Division of Infectious Diseases, St John Hospital & Medical Center, 19251 Mack Avenue, Suite 340, Grosse Pointe Woods, MI 48236, USA. 2Department of Pathology, St John Hospital & Medical Center, 22101 Moross Road, Detroit, MI 48236, USA. 3Department of Internal Medicine, St John Hospital & Medical Center, 22101 Moross Road, Detroit, MI 48236, USA. Authors’ contributions HD wrote the manuscript, collected the images and obtained consent from the patient to publish this case report. RK reviewed the literature and edited the manuscript. FK coordinated care while this patient was hospitalized. LS provided inpatient care for the patient and edited the manuscript. HN reviewed and provided legends for the pathological images. MH reviewed the pathological specimens and made the initial diagnosis. All authors read and approved the final manuscript. Competing interests The authors declare that they have no competing interests. Received: 29 September 2010 Accepted: 25 June 2011 Published: 25 June 2011 References 1. Elhed A, Unutmaz D: Th17 cells and HIV infection. Curr Opin HIV AIDS 2010, 5:146-150. 2. German V, Vassiloyanakopoulos A, Sampaziotis D, Giannakos G: Autoimmune hepatitis in an HIV infected patient that responded to antiretroviral therapy. Scand J Infect Dis 2005, 37:148-151. 3. Puius YA, Dove LM, Brust DG, Shah DP, Lefkowitch JH: Three cases of autoimmune hepatitis in HIV-infected patients. J Clin Gastroenterol 2008, 42:425-429. 4. O’Leary JG, Zachary K, Misdraji J, Chung RT: De novo autoimmune hepatitis during immune reconstitution in an HIV-infected patient receiving highly active antiretroviral therapy. Clin Infect Dis 2008, 46: e12-e14. 5. Wan DW, Marks K, Yantiss RK, Talal AH: Autoimmune hepatitis in the HIV- infected patient: a therapeutic dilemma. AIDS Patient Care STDS 2009, 23:407-413. 6. Vispo E, Maida I, Moreno A, Barreiro P, Soriano V: Autoimmune hepatitis induced by pegylated interferon in an HIV-infected patient with chronic hepatitis C. J Antimicrob Chemother 2008, 62:1470-1472. 7. Coriat R, Podevin P: Fulminant autoimmune hepatitis after successful interferon treatment in an HIV-HCV co-infected patient. Int J STD AIDS 2008, 19:208-210. 8. Cazanave C, Rakotondravelo S, Morlat P, Blanco P, Bonnet F, Beylot J: Autoimmune hepatitis in a HIV-HCV co-infected patient: diagnostic and therapeutic difficulties in French. Rev Med Interne 2006, 27:414-419. 9. Youssef WI, Tavill AS: Connective tissue diseases and the liver. J Clin Gastroenterol 2002, 4:345-349. 10. Yao Q, Frank M, Glynn M, Altman RD: Rheumatic manifestations in HIV-1 infected in-patients and literature review. Clin Exp Rheumatol 2008, 26:799-806. 11. Wanchu A, Sud A, Singh S, Bambery P: Human immunodeficiency virus infection in a patient with systemic lupus erythematosus. J Assoc Physicians India 2003, 51:1102-1104. 12. Calza L, Manfredi R, Colangeli V, D’Antuono A, Passarini B, Chiodo F: Systemic and discoid lupus erythematosus in HIV-infected patients Page 4 of 4 treated with highly active antiretroviral therapy. Int J STD AIDS 2003, 14:356-359. 13. Sommer S, Piyadigamage A, Goodfield MJ: Systemic lupus erythematosus or infection with HIV, or both? Clin Exp Dermatol 2004, 29:393-395. 14. Walker UA, Tyndall A, Daikeler T: Rheumatic conditions in human immunodeficiency virus infection. Rheumatology (Oxford) 2008, 47:952-959. 15. Weiss L, Letimier FA, Carriere M, Maiella S, Donkova-Petrini V, Targat B, Benecke A, Rogge L, Levy Y: In vivo expansion of naive and activated CD4+CD25+FOXP3+ regulatory T cell populations in interleukin-2-treated HIV patients. Proc Natl Acad Sci USA 2010, 107:10632-10637. 16. Lim A, French MA, Price P: CD4+ and CD8+ T cells expressing FoxP3 in HIV-infected patients are phenotypically distinct and influenced by disease severity and antiretroviral therapy. J Acquir Immune Defic Syndr 2009, 51:248-257. 17. Ji J, Cloyd MW: HIV-1 binding to CD4 on CD4+CD25+ regulatory T cells enhances their suppressive function and induces them to home to, and accumulate in, peripheral and mucosal lymphoid tissues: an additional mechanism of immunosuppression. Int Immunol 2009, 21:283-294. 18. Jiao Y, Fu J, Xing S, Fu B, Zhang Z, Shi M, Wang X, Zhang J, Jin L, Kang F, Wu H, Wang FS: The decrease of regulatory T cells correlates with excessive activation and apoptosis of CD8+ T cells in HIV-1-infected typical progressors, but not in long-term non-progressors. Immunology 2009, 128(1 Suppl):e366-e375. doi:10.1186/1752-1947-5-233 Cite this article as: Daas et al.: Human immunodeficiency virus infection and autoimmune hepatitis during highly active anti-retroviral treatment: a case report and review of the literature. Journal of Medical Case Reports 2011 5:233. Submit your next manuscript to BioMed Central and take full advantage of: • Convenient online submission • Thorough peer review • No space constraints or color ﬁgure charges • Immediate publication on acceptance • Inclusion in PubMed, CAS, Scopus and Google Scholar • Research which is freely available for redistribution Submit your manuscript at www.biomedcentral.com/submit