title: Hepatitis C and leptospirosis: simultaneous acute infections or recurrence of occult hepatitis C.
abstract: People who inject drugs are vulnerable to several infections. To the best of our knowledge, this is the first case report of a simultaneous diagnosis of leptospirosis and acute infection or recurrence of occult hepatitis C in an HIV-infected drug user. We report a case of a 47-year-old Caucasian man with HIV infection, on antiretroviral therapy, and with a history of hepatitis C (positive anti-hepatitis C virus (HCV) and HCV RNA persistently negative) who was admitted with febrile acute hepatitis. He was a former injecting drug user, on opioid substitution therapy, who relapsed to injection drug use 3 weeks prior to admission. Work up revealed positive HCV RNA and Leptospira DNA in his urine. Four weeks later he had an undetectable HCV load, and also at 6 months of follow-up. This case highlights the presence of two concomitant infectious aetiologies of acute hepatitis in an HIV-infected drug user.
authors.affiliation: Department of Infectious Diseases, São João's University Hospital, Porto, Portugal.
authors.forename: Rita Veiga
authors.initials: RV
authors.lastname: Ferraz
authors.affiliation: Department of Infectious Diseases, São João's University Hospital, Porto, Portugal.
authors.forename: Nuno Rocha
authors.initials: NR
authors.lastname: Pereira
authors.affiliation: Department of Infectious Diseases, São João's University Hospital, Porto, Portugal.
authors.forename: Cláudia
authors.initials: C
authors.lastname: Carvalho
authors.affiliation: Department of Infectious Diseases, São João's University Hospital, Porto, Portugal.
authors.forename: António
authors.initials: A
authors.lastname: Sarmento
mesh_terms: D060085:Coinfection; D018562:Disease Transmission, Infectious; D015658:HIV Infections / Q000188:drug therapy / Q000276:immunology*; D006526:Hepatitis C / Q000188:drug therapy / Q000276:immunology*; D006801:Humans; D007919:Leptospira / Q000302:isolation & purification*; D007922:Leptospirosis / Q000175:diagnosis / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral; D012008:Recurrence; D015819:Substance Abuse, Intravenous / Q000150:complications* / Q000276:immunology; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D012367:RNA, Viral