An HIV Patient with Hepatic Flare after the Initiation of HBV-Active Antiretroviral Therapy

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 re-constitution associated with resolved HBV infection. © 2012 The Japanese Society of Internal Medicine.