Case Report
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 16, 2025; 13(26): 104421
Published online Sep 16, 2025. doi: 10.12998/wjcc.v13.i26.104421
Hepatitis B virus and hepatitis D virus co-infection complicated by autoimmune hepatitis: Two case reports
Jing Dou, Xin-Yan Zhao, Zhuan-Guo Wang, Zhong-Hui Ning, Xiao-Zhong Wang, Feng Guo
Jing Dou, Zhuan-Guo Wang, Zhong-Hui Ning, Xiao-Zhong Wang, Feng Guo, Department of Hepatology, Traditional Chinese Medicine Hospital Affiliated to Xinjiang Medical University, Urumqi 830000, Xinjiang Uygur Autonomous Region, China
Xin-Yan Zhao, Department of Liver Transplantation Center, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
Author contributions: Dou J and Guo F revised the paper; Dou J contributed to writing and statistical analysis; Zhao XY contributed to issue the pathological reports of the liver; Wang ZG and Ning ZH contributed to data analysis and performing experiments (follow up patients); Wang XZ contributed to resources and supervision; Guo F contributed to study design and conception.
Supported by Xinjiang “Tianshan Talents” Medical and Health High-Level Talent Training Program-Young and Middle-Aged Backbone Medical Talents.
Informed consent statement: Informed consent was obtained from both patients.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Feng Guo, Professor, Department of Hepatology, Traditional Chinese Medicine Hospital Affiliated to Xinjiang Medical University, No. 116 Huanghe Road, Shayibak District, Urumqi 830000, Xinjiang Uygur Autonomous Region, China. gf_sj@163.com
Received: March 19, 2025
Revised: April 2, 2025
Accepted: May 28, 2025
Published online: September 16, 2025
Processing time: 215 Days and 20.8 Hours
Core Tip

Core Tip: This study reports, for the first time, two patients with hepatitis D virus (HDV)-hepatitis B virus co-infection combined with autoimmune hepatitis (AIH) who were not treated with interferon and achieved serological conversion and histological remission with antiviral drugs (entecavir/tenofovir alafenamide) in combination with immunosuppression (prednisone + azathioprine). Patients with severe HDV-related liver disease should be routinely screened for autoantibodies to avoid exacerbation by interferon therapy. The combination therapy was effective in controlling HDV-hepatitis B virus co-infection associated AIH, suggesting that aberrant immunoregulation may be an important mechanism of HDV-induced AIH, providing new evidence for elucidating the pathogenesis of this complex disease, and emphasizing the necessity of immune mechanism research.