An HIV patient with hepatic flare after the initiation of HBV-active antiretroviral therapy.
A 39-year-old man presented a CD4 T cell count of 78/µL and HIV-RNA at 6.6 × 10(5) copies/mL at his first medical examination. After the 58th day, we initiated HBV-active antiretroviral therapy. Three months after the start of antiretroviral therapy, he was diagnosed with hepatic flare on the basis of elevated AST and ALT levels without detecting HBV-DNA. Although after continuing the medication his AST and ALT levels increased to 700 IU/L and 1,400 IU/L, respectively, he showed improvement following a natural course and was discharged from hospital after the 169th day. This is a case of hepatic flare likely caused by immune reconstitution associated with resolved HBV infection.
Department of Infectious Diseases and Infection Control, The Jikei University School of Medicine, Japan. myoshida@jikei.ac.jp
Masaki
M
Yoshida
Tokio
T
Hoshina
Kumi
K
Tamura
Shinji
S
Kawano
Tetsuro
T
Kato
Fumiya
F
Sato
Yasushi
Y
Nakazawa
Koji
K
Yoshikawa
Shoichi
S
Onodera
Seiji
S
Hori
D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D019380:Anti-HIV Agents / Q000627:therapeutic use; D000998:Antiviral Agents / Q000009:adverse effects*; D001219:Aspartate Aminotransferases / Q000097:blood; D018791:CD4 Lymphocyte Count; D015658:HIV Infections / Q000150:complications* / Q000276:immunology / Q000821:virology; D006509:Hepatitis B / Q000150:complications* / Q000188:drug therapy* / Q000276:immunology / Q000821:virology; D006515:Hepatitis B virus / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D054019:Immune Reconstitution Inflammatory Syndrome / Q000209:etiology / Q000276:immunology / Q000821:virology; D008297:Male; D012367:RNA, Viral / Q000097:blood; D019562:Viral Load
D019380:Anti-HIV Agents; D000998:Antiviral Agents; D012367:RNA, Viral; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase