Cross-syndrome of Chronic Hepatitis C and Type 1 Autoimmune Hepatitis with Subsequent Transformation into Type 2 Autoimmune Hepatitis: a Clinical Case

We present clinical case of patient with initially diagnosed chronic hepatitis C with an autoimmune component corresponding to type 1 autoimmune hepatitis. Considering that at the time of diagnosis, the therapeutic possibilities of hepatitis C were limited to the use of standard or pegylated interferon α in combination with ribavirin, in order to avoid the adverse immunomodulatory effect of interferon, we previously suppressed the autoimmune component with immunosuppressors. After 6-month course of prednisolone and azathioprine, antiviral therapy with interferon α and ribavirin was carried out with the achievement of sustained virological and biochemical response. After 7 years of complete virological, immunological and biochemical remission, the patient manifested autoimmune hepatitis type 2. The appointment of prednisolone and azathioprine led to a stable drug-induced remission.