Acute Hepatitis due to Primary Human Immunodeficiency Virus Infection

Eric I Elliott; Daisy Smith; Jonathan Lipscomb; Bubu Banini; Lindsay Meurer; Thomas H Vanderford; Jeffrey A Johnson; Dhanpat Jain; Amit Achhra

doi:10.1093/ofid/ofae170

Acute Hepatitis due to Primary Human Immunodeficiency Virus Infection

Open Forum Infect Dis. 2024 Mar 22;11(4):ofae170. doi: 10.1093/ofid/ofae170. eCollection 2024 Apr.

Authors

Eric I Elliott¹, Daisy Smith², Jonathan Lipscomb³, Bubu Banini⁴, Lindsay Meurer⁵, Thomas H Vanderford⁶, Jeffrey A Johnson⁶, Dhanpat Jain⁷, Amit Achhra¹

Affiliations

¹ Section of Infectious Disease, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA.
² The DESA Group, Inc., Columbia, South Carolina, USA.
³ HIV Laboratory Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
⁴ Section of Digestive Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA.
⁵ Division of Digestive and Liver Diseases, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
⁶ HIV Laboratory, Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
⁷ Department of Pathology, Yale University School of Medicine, New Haven, Connecticut, USA.

Abstract

The acute retroviral syndrome may present with diverse systemic manifestations and laboratory abnormalities. Here we present a rare case of primary human immunodeficiency virus (HIV) infection causing severe acute hepatitis. Liver histopathology demonstrated a pattern of lymphocytic inflammation consistent with acute hepatitis, high levels of HIV proviral DNA were detected within liver tissue, and immunofluorescence showed HIV p24 antigen within immune and parenchymal cells including hepatocytes. We review the literature pertaining to HIV infection of cell compartments within the liver and discuss the implications for HIV-associated acute liver disease.

Keywords: acute HIV infection; acute hepatitis; acute retroviral syndrome; histopathology; human immunodeficiency virus; immunofluorescence; immunohistochemistry; liver; primary HIV infection; proviral DNA.

Publication types

Case Reports

Abstract

Publication types

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