Rapid development of advanced liver fibrosis after acquisition of hepatitis C infection during primary HIV infection.
We report the first reported case of a 61-year-old MSM who was diagnosed with syphilis, primary HIV infection, and acute hepatitis C (HCV) within the same time period who rapidly developed significant liver fibrosis within 6 months of acquisition of both infections. It has been well described that individuals with primary HIV infection have an increase in activated CD8+ T cells, which causes a state of immune activation as was evident in this patient. Acquisition of HCV during this time could have further skewed this response resulting in massive hepatocyte destruction, inflammation, and subsequent liver fibrosis. Recent literature suggest that MSM with primary HIV infection have higher rates of acquisition of HCV than other HIV-positive cohorts and HCV acquisition can occur very soon after acquiring HIV. This case of rapid hepatic fibrosis progression coupled with the increasing incidence of HCV in individuals with primary HIV infection demonstrates a need for this phenomenon to be studied more extensively.
Osinusi
Anu
A
Department of Infectious Diseases, University of Maryland , Baltimore, Maryland, USA.
Kleiner
David
D
Wood
Brad
B
Polis
Michael
M
Masur
Henry
H
Kottilil
Shyam
S
D017088:AIDS-Related Opportunistic Infections / Q000150:complications / Q000188:drug therapy; D000998:Antiviral Agents / Q000627:therapeutic use; D015496:CD4-Positive T-Lymphocytes; D018450:Disease Progression; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D015497:HIV-1; D016174:Hepacivirus; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D018451:Homosexuality, Male; D006801:Humans; D008103:Liver Cirrhosis / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged
D000998:Antiviral Agents