HEPATITIS B VIRUS REACTIVATION IN PATIENTS CO-INFECTED WITH HUMAN IMMUNODEFICIENCY VIRUS: A CASE REPORT.

BACKGROUND

Hepatitis B virus (HBV) reactivation in patients co-infected with human immunodeficiency virus (HIV) represents a serious clinical concern due to shared transmission routes. HIV infection significantly alters the natural course of HBV, resulting in decreased clearance of acute infection, accelerated progression to cirrhosis, and increased liver-related mortality compared to HBV mono-infection.

AIM: To present a severe clinical case of HBV reactivation in a patient with HIV infection complicated by Kaposi sarcoma and to highlight the clinical challenges associated with irregular antiretroviral therapy.

RESULTS

The patient had irregular adherence to antiretroviral therapy and did not receive specific antiviral treatment for hepatitis B. He developed icterus of the skin and sclera accompanied by intermittent low-grade fever. Laboratory investigations revealed elevated transaminases, hyperbilirubinemia, hepatosplenomegaly on ultrasound, periportal fibrosis, and portal hypertension. Despite therapeutic interventions, the patient's condition progressively worsened, characterized by increasing jaundice, profound asthenia, and right upper quadrant discomfort.

CONCLUSION

HBV reactivation in HIV-infected individuals may lead to severe liver complications, particularly in the setting of poor treatment adherence. Patients with chronic hepatitis B and HIV co-infection should receive appropriate counseling regarding liver damage risk and undergo regular surveillance for early detection of hepatocellular carcinoma. Noninvasive methods for liver fibrosis assessment play an important role in monitoring disease progression.