Delayed Diagnosis of Autoimmune Hepatitis Unmasked by Acute Hepatitis A: A Case Report and Literature Review

Introduction: Autoimmune hepatitis (AIH) is a chronic inflammatory liver disease of unknown etiology that can lead to cirrhosis and liver failure if left untreated. Environmental triggers, particularly viral infections, have been implicated in disease onset. Case Presentation: We report the case of a 24-year-old woman who presented with abdominal pain, nausea, and cholestatic jaundice. Initial serological workup revealed acute hepatitis A (HAV) infection. Despite conservative management, liver function continued to deteriorate. Autoimmune screening showed high-titer antinuclear antibodies (ANA), and liver biopsy revealed interface hepatitis with portal lymphoplasmacytic infiltrates and fibrosis (A3F1), consistent with AIH. Conclusion: This case highlights the potential role of HAV infection as a trigger for autoimmune hepatitis. In cases of persistent liver dysfunction after acute viral hepatitis, clinicians should maintain a high index of suspicion for evolving autoimmune liver disease.