First reported cases of hepatitis A virus and human immunodeficiency virus coinfection in Vojvodina, Serbia: A case report

Abstract

Introduction. Hepatitis A virus is the most common cause of acute viral hepatitis, and in people over 25 years of age the disease may have different degrees of severity. Even though hepatitis A virus infection was long believed to be transmitted strictly by fecal-oral route, now this virus is classified among sexually transmitted diseases. Homosexual population, especially those positive for human immunodeficiency virus, is at the greatest risk of hepatitis A virus infection. Case 1. A twenty-six-year-old male homosexual was admitted with clinical and laboratory findings of acute hepatitis. The patient tested positive for enzyme-linked immunosorbent assay immunoglobulin M antibodies to hepatitis A virus and human immunodeficiency virus antibodies, and later on human immunodeficiency virus infection was confirmed by polymerase chain reaction test. After the discharge, the antiretroviral therapy was initiated. Case 2. A twenty-seven-year-old male homosexual was transferred to our clinic from the Regional Hospital, where he was hospitalized due to acute hepatitis A virus infection, after a positive serological test for anti-human immunodeficiency virus antibodies. Human immunodeficiency virus infection was confirmed by polymerase chain reaction test, and upon discharge, antiretroviral therapy was initiated. Conclusion. In order to take the most effective preventive measures, it is very important to identify individuals and groups at high risk of coinfection with human immunodeficiency virus and hepatitis A virus. Timely vaccination against hepatitis A virus among people living with human immunodeficiency virus is recommended and therefore it is necessary to design effective strategies for education of groups at risk.