An HIV patient with hepatic flare after the initiation of HBV-active antiretroviral therapy

Intern Med. 2012;51(12):1623-6. doi: 10.2169/internalmedicine.51.7244. Epub 2012 Jun 15.

Abstract

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.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Alanine Transaminase / blood
  • Anti-HIV Agents / therapeutic use
  • Antiviral Agents / adverse effects*
  • Aspartate Aminotransferases / blood
  • CD4 Lymphocyte Count
  • HIV Infections / complications*
  • HIV Infections / immunology
  • HIV Infections / virology
  • Hepatitis B / complications*
  • Hepatitis B / drug therapy*
  • Hepatitis B / immunology
  • Hepatitis B / virology
  • Hepatitis B virus / genetics
  • Hepatitis B virus / isolation & purification
  • Humans
  • Immune Reconstitution Inflammatory Syndrome / etiology
  • Immune Reconstitution Inflammatory Syndrome / immunology
  • Immune Reconstitution Inflammatory Syndrome / virology
  • Male
  • RNA, Viral / blood
  • Viral Load

Substances

  • Anti-HIV Agents
  • Antiviral Agents
  • RNA, Viral
  • Aspartate Aminotransferases
  • Alanine Transaminase