Persisting HIV-1 replication triggered by acute hepatitis A virus infection.
We report the case of two patients in whom acute hepatitis A was associated with a marked and prolonged increase in human immunodeficiency virus type 1 (HIV-1) viral load. Although in one patient the rise in HIV-1 RNA might also have been related to the interruption of antiretroviral therapy, we also observed a similar pattern in the other patient who had a stable undetectable plasma viraemia prior to acute hepatitis and never received treatment with anti-retrovirals. Our observation supports the hypothesis that immune activation that is induced by acute hepatitis A virus (HAV) infection may trigger HIV-1 replication. This highlights the importance of maintaining antiretroviral therapy throughout the acute phase of hepatitis A and of preventing HAV infection through active immunization.
Ridolfo
A L
AL
Institute of Infectious Diseases and Tropical Medicine, Luigi Sacco Hospital, University of Milan, Italy.
Rusconi
S
S
Antinori
S
S
Balotta
C
C
Galli
M
M
D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000821:virology*; D017320:HIV Protease Inhibitors / Q000627:therapeutic use; D015497:HIV-1 / Q000502:physiology*; D006506:Hepatitis A / Q000150:complications / Q000188:drug therapy / Q000276:immunology*; D006801:Humans; D008297:Male; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use; D019562:Viral Load; D014779:Virus Replication
D019380:Anti-HIV Agents; D017320:HIV Protease Inhibitors; D018894:Reverse Transcriptase Inhibitors