Abu-Heija Ahmad A, Shatta Maya, Yeddi Ahmed, Ravi Anand Kumar, Mutchnick Milton
Internal Medicine, Wayne State University, Detroit, USA.
Gastroenterology, Wayne State University, Detroit, USA.
Cureus. 2018 Dec 20;10(12):e3755. doi: 10.7759/cureus.3755.
Acute retroviral syndrome (ARS) can present as a wide array of clinical manifestations. Establishing a diagnosis early in the disease course can provide an opportunity to minimize immunosuppression and limit further transmission of human immunodeficiency virus (HIV). We present a case of a previously healthy young male who presented with acute hepatitis, as a manifestation of ARS. Initial HIV antigen/antibody testing was negative; however, a high index of suspicion prompted HIV ribonucleic acid (RNA) virologic testing revealing >10 million RNA copies/mL. Anti-retroviral treatment was initiated, along with supportive measures, accomplishing resolution of the transaminitis and the restoration of CD4 counts within normal at one month. Early in the disease course, HIV screening immunoassay could still be negative; hence, confirmatory testing with HIV RNA virologic testing should be pursued when clinical suspicion is high. Prompt diagnosis and treatment can improve outcome and curtail viral transmission.
急性逆转录病毒综合征（ARS）可表现为各种各样的临床表现。在病程早期确立诊断可为尽量减少免疫抑制和限制人类免疫缺陷病毒（HIV）的进一步传播提供机会。我们报告一例既往健康的年轻男性病例，其以急性肝炎作为ARS的一种表现形式。最初的HIV抗原/抗体检测为阴性；然而，高度怀疑促使进行HIV核糖核酸（RNA）病毒学检测，结果显示每毫升RNA拷贝数>1000万。启动了抗逆转录病毒治疗并采取了支持措施，一个月内转氨酶升高得到缓解，CD4细胞计数恢复正常。在病程早期，HIV筛查免疫测定仍可能为阴性；因此，当临床怀疑度高时，应进行HIV RNA病毒学检测以进行确诊。及时诊断和治疗可改善预后并减少病毒传播。
