Acute Hepatitis B Infection in a Patient With Confirmed Immunity on Long-Acting Cabotegravir/Rilpivirine.

IF 0.6 Q4 GASTROENTEROLOGY & HEPATOLOGY ACG Case Reports Journal Pub Date : 2024-12-27 eCollection Date: 2025-01-01 DOI:10.14309/crj.0000000000001575

William K B Boateng, Neil Carlin, Etan Spira, Maria E Szabela, Kosisochukwu J Ezeh

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Abstract

Long-acting injectable formulation of cabotegravir/rilpivirine (CAB/RPV) is a promising novel maintenance therapy for HIV infection. However, coinfection with active hepatitis B virus (HBV) infection is a contraindication to initiating this therapy. Despite guidelines, patients with HBV immunity can still contract acute HBV infection. We report a case of a 30-year-old man with HIV who transitioned from antiretroviral therapy to CAB/RPV and had confirmed HBV immunity. The patient, though asymptomatic, showed significantly elevated liver function tests (LFTs) before his monthly CAB/RPV injection. He was hospitalized and diagnosed with acute HBV infection. His LFTs improved, and he was taken off CAB/RPV and returned to antiretroviral therapy for the treatment of HIV and HBV. During subsequent follow-ups as an outpatient, the patient's LFTs normalized, and his HBV viral load significantly decreased. This case highlights the potential need for routine HBV testing in patients on CAB/RPV therapy.

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长效卡博特韦/利匹韦林免疫的急性乙型肝炎感染患者

长效注射制剂cabotegravir/rilpivirine （CAB/RPV）是一种很有前途的新型HIV感染维持疗法。然而，合并活动性乙型肝炎病毒（HBV）感染是开始这种治疗的禁忌症。尽管有指南，但HBV免疫的患者仍可能感染急性HBV感染。我们报告一例30岁的艾滋病毒感染者，他从抗逆转录病毒治疗过渡到CAB/RPV，并证实HBV免疫。患者虽然无症状，但在每月进行CAB/RPV注射前，肝功能测试（LFTs）明显升高。他住院并被诊断为急性HBV感染。他的LFTs有所改善，他被取消了CAB/RPV，并重新接受抗逆转录病毒治疗，以治疗HIV和HBV。在随后的门诊随访中，患者的LFTs恢复正常，HBV病毒载量显著下降。本病例强调了在接受CAB/RPV治疗的患者中进行常规HBV检测的潜在需求。

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来源期刊

ACG Case Reports Journal GASTROENTEROLOGY & HEPATOLOGY-

自引率

14.30%

发文量

170

审稿时长

12 weeks

期刊介绍： ACG Case Reports Journal is a peer-reviewed, open-access publication that provides GI and hepatology fellows, private practice clinicians, and other healthcare providers an opportunity to share interesting case reports with their peers and with leaders in the field. ACG Case Reports Journal publishes case reports, images, videos and letters to the editor in all topics of gastroenterology and hepatology, including: Biliary Colon Endoscopy Esophagus Functional Bowel Disorders Inflammatory Bowel Disease Liver Nutrition and Obesity Pancreas Pathology Pediatric Small Bowel Stomach.