Epstein-Barr Virus Infection as A Trigger of Autoimmune Hepatitis: Case Report

The study underlines the importance of the differential diagnosis between primary Epstein-Barr virus EBV associated hepatitis with features of autoimmunity, in which there is a direct pathogenetic role of the virus, and EBV related autoimmune hepatitis, in which EBV could act as the trigger of the immune-mediated damage with probable differences between the two conditions with regard to the prognosis and the responsiveness to immunosuppressive treatment. Moreover we hypothesise that the favourable outcome in our patient, better than the most of autoimmune hepatitis cases, may be related either to the moderate necroinflammatory activity and to the low level of fibrosis at the beginning of the disease or to the role of EBV as a trigger of autoimmune hepatitis. The hypothesis that EBV-related autoimmune hepatitis could have a more favourable prognosis than the most of autoimmune hepatitis cases in general need to be confirmed on a larger series of studies.