Evidence map›Paper›PMID 38802753›Full record

ArticleBMC infectious diseases2024

A complex case study: coexistence of multi-drug-resistant pulmonary tuberculosis, HBV-related liver failure, and disseminated cryptococcal infection in an AIDS patient.

Wei Fu, Zi Wei Deng, Pei Wang, Zhen Wang Zhu, Ye Pu, Zhi Bing Xie, Yong Zhong Li, Hong Ying Yu

Abstract readCase Reports
In one paragraph

Article in BMC infectious diseases, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Wei Fu *Center for Infectious Diseases, Hunan University of Medicine General Hospital, Huaihua, Hunan, China.
Zi Wei Deng *Department of Clinical Pharmacy, Hunan University of Medicine General Hospital, Huaihua, Hunan, China.
Pei WangCenter for Infectious Diseases, Hunan University of Medicine General Hospital, Huaihua, Hunan, China.
Zhen Wang ZhuCenter for Infectious Diseases, Hunan University of Medicine General Hospital, Huaihua, Hunan, China.
Ye PuCenter for Infectious Diseases, Hunan University of Medicine General Hospital, Huaihua, Hunan, China.
Zhi Bing XieCenter for Infectious Diseases, Hunan University of Medicine General Hospital, Huaihua, Hunan, China.
Yong Zhong LiCenter for Infectious Diseases, Hunan University of Medicine General Hospital, Huaihua, Hunan, China.
Hong Ying YuCenter for Infectious Diseases, Hunan University of Medicine General Hospital, Huaihua, Hunan, China. yhy19959@163.com.

Funding

Scientific Research Project of Hunan Public Health Alliance No. ky2022-002
6 · The paper itself

Abstract

backgroundHepatitis B virus (HBV) infection can cause liver failure, while individuals with Acquired Immunodeficiency Virus Disease (AIDS) are highly susceptible to various opportunistic infections, which can occur concurrently. The treatment process is further complicated by the potential occurrence of immune reconstitution inflammatory syndrome (IRIS), which presents significant challenges and contributes to elevated mortality rates. CASE PRESENTATION: The 50-year-old male with a history of chronic hepatitis B and untreated human immunodeficiency virus (HIV) infection presented to the hospital with a mild cough and expectoration, revealing multi-drug resistant pulmonary tuberculosis (MDR-PTB), which was confirmed by XpertMTB/RIF PCR testing and tuberculosis culture of bronchoalveolar lavage fluid (BALF). The patient was treated with a regimen consisting of linezolid, moxifloxacin, cycloserine, pyrazinamide, and ethambutol for tuberculosis, as well as a combination of bictegravir/tenofovir alafenamide/emtricitabine (BIC/TAF/FTC) for HBV and HIV viral suppression. After three months of treatment, the patient discontinued all medications, leading to hepatitis B virus reactivation and subsequent liver failure. During the subsequent treatment for AIDS, HBV, and drug-resistant tuberculosis, the patient developed disseminated cryptococcal disease. The patient's condition worsened during treatment with liposomal amphotericin B and fluconazole, which was ultimately attributed to IRIS. Fortunately, the patient achieved successful recovery after appropriate management.

conclusionEnhancing medical compliance is crucial for AIDS patients, particularly those co-infected with HBV, to prevent HBV reactivation and subsequent liver failure. Furthermore, conducting a comprehensive assessment of potential infections in patients before resuming antiviral therapy is essential to prevent the occurrence of IRIS. Early intervention plays a pivotal role in improving survival rates.

Indexed as

CryptococcosisTuberculosis, Multidrug-ResistantTuberculosis, PulmonaryAcquired Immunodeficiency SyndromeAIDS-Related Opportunistic InfectionsAntitubercular AgentsCoinfectionHepatitis B, ChronicHIV InfectionsHumansLiver FailureMaleMiddle AgedAntitubercular AgentsAIDSDisseminated cryptococcal diseaseIRISLiver failureMDR-PTB

Identifiers

PMID38802753
PMCPMC11129448

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