Journal of
AIDS and HIV Research

  • Abbreviation: J. AIDS HIV Res.
  • Language: English
  • ISSN: 2141-2359
  • DOI: 10.5897/JAHR
  • Start Year: 2009
  • Published Articles: 283

Case Report

Elevated liver transaminases, human immune deficiency virus (HIV) seroconversion and rapid progression to AIDS in a HIV prevention clinical trial participant: A case report

Khatija Ahmed
  • Khatija Ahmed
  • Setshaba Research Centre, Soshanguve, Pretoria, South Africa.
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Mookho Malahleha
  • Mookho Malahleha
  • Setshaba Research Centre, Soshanguve, Pretoria, South Africa.
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JenniferDeese
  • JenniferDeese
  • FHI 360, Research Triangle Park, North Carolina, USA.
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Constance Monedi
  • Constance Monedi
  • Setshaba Research Centre, Soshanguve, Pretoria, South Africa.
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Lut Van Damme
  • Lut Van Damme
  • FHI 360, Research Triangle Park, North Carolina, USA.
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  •  Accepted: 13 March 2013
  •  Published: 31 March 2013

Abstract

This is a case report on a human immune deficiency virus (HIV) prevention trial participant who HIV seroconverted, developed hepatitis and rapidly progressed to acquired immunodeficiency syndrome (AIDS). A 24 year old HIV negative, non-pregnant participant consented to participate in the FEM-PrEP clinical trial. Her baseline parameters were normal; she was on oral contraception and was vaccinated for hepatitis B. She attended monthly scheduled visits and protocol specific procedures were done. She HIV seroconverted at her week 36 follow up visit, and her aspartate aminotransferases (ASTs) and alanine aminotransferases (ALTs) were elevated to a grade 3 level (DAIDs grading). Over her next follow up visits, there were fluctuations in her AST and ALTs and she had a history of using herbal medication. She rapidly progressed to AIDS and was started on anti-retroviral (ARVs). The participant was in the Truvada arm of the study. This case of hepatic toxicity and rapid HIV progression demonstrates the clinical complexity of HIV management in clinical trials. We hypothesize that the hepatic toxicity was associated with acute HIV infection and concomitant use of herbal medicine; however, we cannot definitively demonstrate causality. 

Key words: HIV prevention, seroconversion, elevated transaminases, STDs, liver toxicity, herbal medication, antibiotics, oral contraception, rapid progression to AIDS.