Hepatocellular Carcinoma in Patients With Liver Cirrhosis Secondary to Autoimmune Hepatitis: A Case Series and Literature Review

Autoimmune hepatitis (AIH) is a known risk factor for the development of hepatocellular carcinoma (HCC). However, the current clinical guidelines do not offer a systematic approach to the surveillance and follow-up of patients with AIH to help with the diagnosis and treatment of HCC in this patient population. In this case series, we describe the clinical presentation and management of eight patients who were diagnosed with HCC secondary to underlying AIH at the University of Florida Health Shands Hospital. Throughout their treatment course, all eight patients were identified to have either histological or radiological evidence of liver cirrhosis. Furthermore, all of them tested negative for chronic viral hepatitis serologies and denied any history of excessive alcohol consumption. The median time interval between AIH diagnosis and HCC development in this cohort was 48 months. All demographic, clinical, and laboratory findings were summarized and compared to the relevant data in the existing literature. Our findings suggest that patients diagnosed with AIH would benefit from liver cirrhosis screening and, if present, they should adhere to a regular HCC surveillance schedule.