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Acute Hepatitis E Virus Infection in an HIV-Infected Person in the United States
- Jennifer A. Curry, MD;
- Nehkonti Adams, MD; and
- Nancy F. Crum-Cianflone, MD, MPH
- From Naval Medical Center, San Diego, CA 92134, and Uniformed Services University of Health Sciences, Bethesda, MD 20814.
Background: Hepatitis E virus (HEV) is an enterically transmitted cause of viral hepatitis that is rarely noted without international travel.
Objective: To report the first case of an HIV-infected man with acute hepatitis due to HEV infection who had not traveled outside the United States.
Case Report: A 45-year-old HIV-positive man had mildly elevated aminotransferase levels that were asymptomatic. He had a CD4 cell count of 0.36 × 109 cells/L (31%) with undetectable HIV RNA (<50 copies/mL) while receiving abacavir–lamivudine, atazanavir, and ritonavir. He had visited Maine and Illinois 4 weeks previously but reported no exposure to sick persons, nonmunicipal water, or farm animals; international travel; or medication changes. He reported having had anonymous sexual partners but did not report alcohol or illicit drug use.
Over the next week, the patient developed low-grade fever, abdominal tenderness, fatigue, and diffuse myalgias. Examination revealed right upper-quadrant tenderness with a palpable liver edge. Repeated laboratory testing revealed levels of alanine aminotransferase at 1396 U/L (normal range, 0 to 45 U/L), aspartate aminotransferase at 810 U/L …
This 100-word excerpt has been provided in the absence of an abstract.
