Acute Hepatitis and Esophageal Candidiasis During Primary Human Immunodeficiency Virus Infection

Margareth da Eira, Ivelise Maria Moreira, Rúbia Jalva da Costa Silva, Edison José Boccardo, Meire Bócoli Rossi, Luís Fernando de Macedo Brígido


    Primary human immunodeficiency virus infection (PHI) may take place without symptoms or may be associated with mononucleosislike illness. Sometimes, the clinical presentation includes aseptic meningitis, mucocutaneous ulcers, oropharyngeal candidiasis and elevated aminotransferases. We describe the case of a 25-year-old male, who had sex with other men, and presented to the emergency department with elevated aminotransferases levels and esophageal candidiasis. Acute hepatitis markers (hepatitis A, B, C, Epstein-Barr virus and cytomegalovirus) were performed and all were negative. Repeated testes revealed 3 consecutive negative HIV antibody tests with a strongly high HIV-1 RNA plasma concentration (> 500,000 copies /mL) and a loss of CD4+ T cells (347 cells/µL), characterizing an acute hepatitis occurring during a course of an acute retroviral syndrome. Antiretroviral therapy was started while waiting a genotyping test performed to assess the presence of potential drug resistance mutations, and the patient recovered uneventfully, with normalization of aminotransferases, CD4 restoration and viral load become undetectable. Genotyping test indicated primary antiretroviral mutations, and appropriate changes in antiretroviral therapy were performed. Our case like other reports suggested that a diagnosis of PHI needs to be considered in patients who presented with acute hepatitis.



Acute HIV infection; Acute retroviral syndrome; Hepatitis; Primary HIV infection; Esophageal candidiasis

Full Text: HTML PDF
Home     |     Log In     |      About     |      Search     |      Current     |      Archives     |      Submit      |     Subscribe



Aims and Scope

Current Issues

Conflict of Interest

About Publisher

Editorial Board



Company Profile

Editorial Office

Misconduct and Retraction


Company Registration

Contact Us

Abstracting and Indexing



Instructions to Authors


Declaration of Helsinki

Contact Publisher

Submission Checklist


Terms of Use

Company Address

Submit a Manuscript

Open Access Policy

Privacy Policy

Browse Journals

Publishing Fee

Publishing Policy


Recent Highlights

Peer-Review Process

Publishing Quality

Code of Ethics

Advertising Policy

Manuscript Tracking

Advanced Search

For Librarians


Publishing Process

Publication Frequency

For Reviewers

Propose a New Journal


Journal of Medical Cases, monthly, ISSN 1923-4155 (print), 1923-4163 (online), published by Elmer Press Inc.        
The content of this site is intended for health care professionals.
This is an open-access journal distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License, which permits unrestricted
non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Creative Commons Attribution license (Attribution-NonCommercial 4.0 International CC-BY-NC 4.0)

This journal follows the International Committee of Medical Journal Editors (ICMJE) recommendations for manuscripts submitted to biomedical journals,
the Committee on Publication Ethics (COPE) guidelines, and the Principles of Transparency and Best Practice in Scholarly Publishing.

website:   editorial contact:
Address: 9225 Leslie Street, Suite 201, Richmond Hill, Ontario, L4B 3H6, Canada

© Elmer Press Inc. All Rights Reserved.