Cerebral Venous Thrombosis as The Sole Presenting Manifestation of Human Immunodeficiency Virus and Hepatitis B Virus Co-Infection
Main Article Content
Abstract
Background: Cerebral venous thrombosis (CVT) following either human immunodeficiency virus (HIV) infection or hepatitis B virus (HBV) infection is a very rare condition. Moreover, it has never been reported as the presenting manifestation of HIV and HBV co-infection, even more so when the patient had a normal CD4 count and no demonstrable opportunistic infections. We aimed to report the first case of an adult Indian male, an intravenous drug abuser who developed CVT as the presenting manifestation of HIV-HBV co-infection.
Methods: Patient data were obtained from medical records from the Bangur Institute of Neurosciences, Institute of Post Graduate Medical Education and Research & SSKM Hospital, Kolkata, West Bengal, India.
Results: A 25-year-old male with a history of intravenous drug abuse and a normal CD4 count developed CVT as the presenting manifestation of HIV-HBV co-infection. His CD4 count was normal, and he had no demonstrable opportunistic infections. He had an uneventful recovery of the condition (CVT) following the institution of conventional anticoagulation therapy alongside anti-retroviral therapy.
Conclusion: Whether illicit drug abuse or HIV/HBV infection itself or all in combination led to this thrombotic event cannot be precisely established. Notwithstanding, we recommend serologic testing for HIV and HBV in patients suffering from CVT with high-risk behavior.
Keywords:
HIV, HBV, Co-infection, Cerebral venous thrombosis
Article Details
How to Cite
DUTTA, Ajitava et al.
Cerebral Venous Thrombosis as The Sole Presenting Manifestation of Human Immunodeficiency Virus and Hepatitis B Virus Co-Infection.
Medical Research Archives, [S.l.], v. 10, n. 10, oct. 2022.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/3197>. Date accessed: 22 dec. 2024.
doi: https://doi.org/10.18103/mra.v10i10.3197.
Section
Case Reports
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
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22. Sule AA, Pandit N, Handa P, et al. Risk of Venous Thromboembolism in Patients Infected with HIV: A Cohort Study. Int J Angiol. 2013;22(2):95-100. doi:10.1055/s-0033-1333866
23. Rokx C, Borjas Howard JF, Smit C, et al. Risk of recurrent venous thromboembolism in patients with HIV infection: A nationwide cohort study. PLoS Med. 2020;17(5):e1003101. Published 2020 May 14. doi:10.1371/journal.pmed.1003101
24. Matta F, Yaekoub AY, Stein PD. Human immunodeficiency virus infection and risk of venous thromboembolism. Am J Med Sci. 2008;336(5):402-406. doi:10.1097/MAJ.0b013e31816dd2fd
25. Hooper WC, Phillips DJ, Ribeiro MJ, et al. Tumor necrosis factor-alpha downregulates protein S secretion in human microvascular and umbilical vein endothelial cells but not in the HepG-2 hepatoma cell line. Blood. 1994;84(2):483-489.
26. Berger JR, Harris JO, Gregorios J, Norenberg M. Cerebrovascular disease in AIDS: a case-control study. AIDS. 1990;4(3):239-244. doi:10.1097/00002030-199003000-00010
27. Hassoun A, Al-Kadhimi Z, Cervia J. HIV infection and antiphospholipid antibody: literature review and link to the antiphospholipid syndrome. AIDS Patient Care STDS. 2004;18(6):333-340. doi:10.1089/1087291041444032
28. Rasmussen LD, Dybdal M, Gerstoft J, et al. HIV and risk of venous thromboembolism: a Danish nationwide population-based cohort study. HIV Med. 2011;12(4):202-210. doi:10.1111/j.1468-1293.2010.00869.x
29. Genet P, Courdavault L, Wifaq B, Gerbe J. Symptomatic mixed cryoglobulinemia during HIV primary infection: a case report. Case reports in infectious diseases. Epub 2011 Nov 20.
30. Della Rossa A, Tavoni A, Bombardieri S. Hyperviscosity syndrome in cryoglobulinemia: clinical aspects and therapeutic considerations. Semin Thromb Hemost. 2003;29(5):473-477. doi:10.1055/s-2003-44555
31. Ghosh R, León-Ruiz M, Roy D, Naga D, Sardar SS, Benito-León J. Cerebral venous sinus thrombosis following Russell's viper (Daboia russelii) envenomation: A case report and review of the literature [published online ahead of print, 2022 Aug 27]. Toxicon. 2022;218:8-12. doi:10.1016/j.toxicon.2022.08.014
32. Roy D, Ghosh R, Dubey S, Dubey MJ, Benito-León J, Kanti Ray B. Neurological and Neuropsychiatric Impacts of COVID-19 Pandemic. Can J Neurol Sci. 2021;48(1):9-24. doi:10.1017/cjn.2020.173
33. Dutta A, Ghosh R, Bhattacharya D, et al. Anti-PF4 antibody negative cerebral venous sinus thrombosis without thrombocytopenia following immunization with COVID-19 vaccine in an elderly non-comorbid Indian male, managed with conventional heparin-warfarin based anticoagulation. Diabetes Metab Syndr. 2021;15(4):102184. doi:10.1016/j.dsx.2021.06.021
2. Boissé L, Gill MJ, Power C. HIV infection of the central nervous system: clinical features and neuropathogenesis. Neurol Clin. 2008;26(3):799-x. doi:10.1016/j.ncl.2008.04.002
3. Modi M, Singla V, Ahluwalia J, et al. HIV infection presenting as cerebral venous sinus thrombosis. Am J Emerg Med. 2012;30(3):517.e1-517.e5173. doi:10.1016/j.ajem.2011.01.022
4. Mwita JC, Baliki K, Tema L. Cerebral venous sinus thrombosis in HIV-infected patients: report of 2 cases. Pan Afr Med J. 2013;16:4. Published 2013 Sep 4. doi:10.11604/pamj.2013.16.4.3252
5. Netravathi M, Jaychandran R, Bhat M, Christopher R, Satishchandra P. Profile of 26 HIV Seropositive individuals with Cerebral Venous Thrombosis. J Neurol Sci. 2017;378:69-74. doi:10.1016/j.jns.2017.04.034
6. Galli L, Gerdes VE, Guasti L, Squizzato A. Thrombosis Associated with Viral Hepatitis. J Clin Transl Hepatol. 2014;2(4):234-239. doi:10.14218/JCTH.2014.00031
7. Zis P, Kontogeorgi E, Karakalos D, Pavlopoulou D, Sevastianos VA. Cerebral venous thrombosis as an extrahepatic manifestation of acute anicteric hepatitis a infection. Case Rep Neurol Med. 2012;2012:120423. doi:10.1155/2012/120423
8. Pérez S, Casado I, García I, Gómez M, Ramírez JM, Luengo E. Infarto hemorrágico por trombosis del seno transverso como complicación de la cirrosis [Hemorrhagic infarct as a result of cerebral venous thrombosis as a complication of cirrhosis]. Rev Neurol. 1999;29(12):1355-1356.
9. Felício AC, Fukujima MM, Fiorot JA Jr, et al. Cerebral venous thrombosis and hepatitis: case report. Arq Neuropsiquiatr. 2006;64(4):1041-1042. doi:10.1590/s0004-282x2006000600033
10. Shan F, Gao C, Long Y, et al. Cerebral venous sinus thrombosis may be associated with hepatitis B virus infection: a preliminary finding. Neurol Res. 2015;37(6):510-513. doi:10.1179/1743132815Y.0000000003
11. Rao SM, Khardenavis S, Deshpande A, Pandi S. Case report of isolated vein of trolard thrombosis in an HBsAg-positive patient. Medical Journal of Dr. DY Patil University; 2014;1;7(2):222.
12. Nadir A, Amin A, Chalisa N, van Thiel DH. Retinal vein thrombosis associated with chronic hepatitis C: a case series and review of the literature. J Viral Hepat. 2000;7(6):466-470. doi:10.1046/j.1365-2893.2000.00245.x
13. Zachou K, Liaskos C, Christodoulou DK, et al. Anti-cardiolipin antibodies in patients with chronic viral hepatitis are independent of beta2-glycoprotein I cofactor or features of antiphospholipid syndrome. Eur J Clin Invest. 2003;33(2):161-168. doi:10.1046/j.1365-2362.2003.01110.x
14. Murthy BV, Wenstone R. Cerebral venous thrombosis associated with inhalational drug abuse. Rhinology. 1996;34(3):188-190.
15. Burns H, Rich P, Al-memar AY. An unpleasant hit from cocaine: a case of cocaine-induced cerebral venous sinus thrombosis. Journal of Neurology, Neurosurgery and Psychiatry. 2012;1;83:A1.
16. Degenhardt L, Peacock A, Colledge S, et al. Global prevalence of injecting drug use and sociodemographic characteristics and prevalence of HIV, HBV, and HCV in people who inject drugs: a multistage systematic review [published correction appears in Lancet Glob Health. 2017 Nov 15;:]. Lancet Glob Health. 2017;5(12):e1192-e1207. doi:10.1016/S2214-109X(17)30375-3
17. Konin C, Adoh M, Adoubi A, et al. Thromboses veineuses inhabituelles révélatrices d'une infection par le virus de l'immunodéficience humaine et d'un déficit en protéine S. A propos de deux cas et revue de la littérature [Unusual venous thrombosis revealing a human immunodeficiency virus infection and a protein S deficiency. Two cases and literature review]. Rev Med Interne. 2008;29(6):508-511. doi:10.1016/j.revmed.2007.12.022
18. Rakhra A, Kiefer LE, Busireddy KR, Sankaraneni R. Cerebral Venous Sinus Thrombosis in an Immunocompetent HIV Patient. Cureus. 2021;13(3):e13694. Published 2021 Mar 4. doi:10.7759/cureus.13694
19. Okudo J, Civelli VF, Narang VK, et al. A Rare Case of Cryptococcus gattii Meningitis in Advanced HIV Disease, Sagittal Thrombosis, and Immune Reconstitution Syndrome, Resolved With Isavuconazonium. J Investig Med High Impact Case Rep. 2020;8:2324709620959880. doi:10.1177/2324709620959880
20. Modi M, Singla V, Ahluwalia J, et al. HIV infection presenting as cerebral venous sinus thrombosis. Am J Emerg Med. 2012;30(3):517.e1-517.e5173. doi:10.1016/j.ajem.2011.01.022
21. Dillmon MS, Saag MS, Hamza SH, Adler BK, Marques MB. Unusual thromboses associated with protein S deficiency in patients with acquired immunodeficiency syndrome: case reports and review of the literature. AIDS Res Hum Retroviruses. 2005;21(9):753-756. doi:10.1089/aid.2005.21.753
22. Sule AA, Pandit N, Handa P, et al. Risk of Venous Thromboembolism in Patients Infected with HIV: A Cohort Study. Int J Angiol. 2013;22(2):95-100. doi:10.1055/s-0033-1333866
23. Rokx C, Borjas Howard JF, Smit C, et al. Risk of recurrent venous thromboembolism in patients with HIV infection: A nationwide cohort study. PLoS Med. 2020;17(5):e1003101. Published 2020 May 14. doi:10.1371/journal.pmed.1003101
24. Matta F, Yaekoub AY, Stein PD. Human immunodeficiency virus infection and risk of venous thromboembolism. Am J Med Sci. 2008;336(5):402-406. doi:10.1097/MAJ.0b013e31816dd2fd
25. Hooper WC, Phillips DJ, Ribeiro MJ, et al. Tumor necrosis factor-alpha downregulates protein S secretion in human microvascular and umbilical vein endothelial cells but not in the HepG-2 hepatoma cell line. Blood. 1994;84(2):483-489.
26. Berger JR, Harris JO, Gregorios J, Norenberg M. Cerebrovascular disease in AIDS: a case-control study. AIDS. 1990;4(3):239-244. doi:10.1097/00002030-199003000-00010
27. Hassoun A, Al-Kadhimi Z, Cervia J. HIV infection and antiphospholipid antibody: literature review and link to the antiphospholipid syndrome. AIDS Patient Care STDS. 2004;18(6):333-340. doi:10.1089/1087291041444032
28. Rasmussen LD, Dybdal M, Gerstoft J, et al. HIV and risk of venous thromboembolism: a Danish nationwide population-based cohort study. HIV Med. 2011;12(4):202-210. doi:10.1111/j.1468-1293.2010.00869.x
29. Genet P, Courdavault L, Wifaq B, Gerbe J. Symptomatic mixed cryoglobulinemia during HIV primary infection: a case report. Case reports in infectious diseases. Epub 2011 Nov 20.
30. Della Rossa A, Tavoni A, Bombardieri S. Hyperviscosity syndrome in cryoglobulinemia: clinical aspects and therapeutic considerations. Semin Thromb Hemost. 2003;29(5):473-477. doi:10.1055/s-2003-44555
31. Ghosh R, León-Ruiz M, Roy D, Naga D, Sardar SS, Benito-León J. Cerebral venous sinus thrombosis following Russell's viper (Daboia russelii) envenomation: A case report and review of the literature [published online ahead of print, 2022 Aug 27]. Toxicon. 2022;218:8-12. doi:10.1016/j.toxicon.2022.08.014
32. Roy D, Ghosh R, Dubey S, Dubey MJ, Benito-León J, Kanti Ray B. Neurological and Neuropsychiatric Impacts of COVID-19 Pandemic. Can J Neurol Sci. 2021;48(1):9-24. doi:10.1017/cjn.2020.173
33. Dutta A, Ghosh R, Bhattacharya D, et al. Anti-PF4 antibody negative cerebral venous sinus thrombosis without thrombocytopenia following immunization with COVID-19 vaccine in an elderly non-comorbid Indian male, managed with conventional heparin-warfarin based anticoagulation. Diabetes Metab Syndr. 2021;15(4):102184. doi:10.1016/j.dsx.2021.06.021