Comparison of clinical characteristics of amebic liver abscess in human immunodeficiency virus (HIV)-infected and non-HIV-infected patients
Kuan-Sheng Wu, Hung-Chin Tsai, Susan Shin-Jung Lee, Yung-Ching Liu, Shue-Ren Wann, Yung-Hsing Wang, Ming-Hsin Mai, Jei-Kuang Chen, Cheng-Len Sy, Kung-Ming Chen, Yi-Jan Chen, Yao-Shen Chen
Section of Infectious Diseases, Department of Medicine, and Section of Microbiology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
Received: July 2, 2007 Revised: July 24, 2007 Accepted: August 31, 2007
Background and purpose:
Amebic liver abscess is an emerging parasitic disease in human immunodeficiency virus (HIV)-infected patients. Clinical characteristics of this disease have rarely been compared between patients with and without HIV infection.
This retrospective study included 24 patients who had been diagnosed with amebic liver abscess during a 17-year period. The demographics, clinical manifestations, radiographic findings, and outcomes were compared between HIV-infected and non-HIV-infected patients.
Among 24 patients with amebic abscess, 8 were HIV-infected and 16 were non-HIV-infected. The mean (± standard deviation [SD]) age of HIV-infected patients was 41.0 ± 11.3 years (range, 27-62 years), which was younger than that of the non-HIV-infected group (58.5 ± 14.6 years; range, 27-77 years; p=0.01). Compared with non-HIV-infected controls, patients with HIV infection had lower white blood cell counts (median, 17.2 × 109/L vs 10.4 × 109/L; p=0.01), neutrophil/lymphocyte (N/L) ratio (median, 12.1 vs 2.7; p<0.01), total bilirubin (median, 42.7 µmol/L vs 13.7 µmol/L; p=0.02), blood urea nitrogen (median, 7.9 mmol/L vs 4.1 mmol/L; p=0.04), and creatinine (median, 114.9 µmol/L vs 88.4 µmol/L; p<0.01). On multivariate analysis, low N/L ratio remained a significant predictor for HIV infection (odds ratio, 0.49; 95% confidence interval, 0.264-0.912; p=0.024). No significant differences were observed in clinical manifestations, radiographic findings, and indirect hemagglutination titer between the 2 groups.
HIV-infected patients with amebic liver abscess tended to have a lower N/L ratio than non-HIVinfected comparators.
Entamoeba histolytica; HIV infections; Liver abscess, amebic; Taiwan
J Microbiol Immunol Infect. 2008;41:456-461.