Primary biliary cholangitis triggered by DAAs-induced HCV clearance: a biological proof of concept

Chronic hepatitis C (CHC) is the major cause of liver cirrhosis; traditionally the standard of care was pegylated interferon alpha (PEG-IFNα) and ribavirin. Due to this cytokine’s immunological properties, accurate immunological screening was mandatory before starting therapy and the treatment was contraindicated in patients with concomitant autoimmune diseases. Several reports of the onset of autoimmune hepatic disease after CHC treatment with IFN have been made.1 Novel IFN-free regimens have dramatically reduced the risk of this complication, and recent guidelines2 no longer list autoimmune disorders as an absolute contraindication. Nevertheless, we report the first case of a patient in whom hepatitis C virus (HCV) eradication by an IFN-free regimen unmasked primary biliary cholangitis (PBC)