Hepatocellular Carcinoma during HIV/HBV Co-Infection

Abstract

HIV/HBV Co-infection constitute a public health problem in sub-Saharan Africa. Its prognosis is high because of late diagnosis. We are reporting a case of HIV/ HBV co-infection detected at the stage of hepatocellular carcinoma with the aim of contributing to a better care for cases of HBV and HIV co-infection. This is about a 43 year-old adult co-infected with HBV and HIV-1. Upon admission into the Department of Infectious Diseases, the review noted a maintained general condition, an icteric conjunctiva, a conjunctival pallor, a weight equal to 60 kg, there was neither dehydration, any hepato splenomegaly or collateral venous circulation. Laboratory tests showed moderate immunosuppression (CD4 = 260/ mm3), moderate anemia (Hb rate = 11, 4 g/dl), thrombocytopenia (platelets = 127 000 /mm3), high alpha fetoproteins (1800 U/ml), on fibrotest the fibrosis score was equal to 0.9 and the activity score to 0.9; Gamma GT = 91 U/l, total Bilirubin = 81.11 micromol/l (N <25.7), a prothrombin rate = 71.70% (N = 70-100), IgM antiHBc = negative. Hepatic ultrasound objectified appearance compatible with cirrhosis. The diagnosis is a post viral hepatitis B hepatocellular carcinoma complicating cirrhosis. HBV/HIV co-infection is serious because of the rapid progression to cirrhosis and hepatocellular carcinoma. Routine screening of viral hepatitis B which is an AIDS marker in HIV-positive people will allow a holistic medical care, necessary to prevent hepatocellular carcinoma