Liver failure associated with autoimmune hepatitis in the presence of active infections by Epstein‒Barr virus and cytomegalovirus: a case report.

Liver failure occurs due to extensive hepatocellular damage and may be induced by several etiologies, including autoimmunity and hepatotropic and non-hepatotropic viruses. Cytomegalovirus (CMV) and Epstein‒Barr virus (EBV) are viruses from the Herpesviridae family that usually cause latent infections but may trigger severe liver disease and dysfunction. Herein, we report a case of a 48-year-old female patient with jaundice, coagulopathy, encephalopathy, hyperbilirubinemia, and autoimmunity marker. The patient was referred to a public hospital in Rio de Janeiro, Brazil, and underwent a liver transplant. Serological and molecular diagnosis showed active infections by EBV and CMV. The presence of latent or active infection by EBV or CMV needs to be investigated in patients with liver failure of unknown etiology, which might trigger severe autoimmune hepatitis.