Late presenter patient with HIV/SARS-CoV-2 coinfection

Abstract

Introduction. Late presentation of a large number of HIV-infected patients remains an important public health problem. The current SARS-CoV-2 pandemic has had serious consequences for health services, especially for patients living with HIV, who had limited access to health facilities, leading to a delayed diagnosis and initiation of antiretroviral treatment (ART), as well as to an increased mortality. Case presentation. We describe the case of a 55-year-old patient, from a rural area, who was admitted to Emergency County Hospital Targu Jiu in November 2022 reporting significant weight loss (5 kg in one month), physical fatigue, dizziness, headache, loss of appetite, diarrhea, symptoms that occurred 3 months ago. Elisa test-HIV1,2 was performed, with a positive result and the patient was transferred to the HIV/AIDS Department - ”Victor Babes” Clinical Hospital ofInfectious Diseases and Pneumophtisiology Craiova. It was performed SARS-CoV-2 Rapid Antigen Test and the result was positive. Head computed tomography revealed lesions of cerebral toxoplasmosis. The patient underwent treatment with antibiotics, antifungals, cerebral depletives, corticosteroids, gastroprotective drugs, vitamins, parenteral hydro-electrolytic rebalancing therapy and symptomatic drugs. ART was initiated 2 weeks after the diagnosis, with favorable evolution. At 3 months after ART initiation, the CD4 cell count increased to 120 cells/mm3 and VL-HIV was undetectable. Conclusions. In the context of the COVID-19 pandemic, late presentation for HIV/AIDS has been more common globally. Prompt treatment of opportunistic infection and then ART initiation led to a slowly favorable evolution in a patient with confirmed SARS-CoV-2 infection.