Characteristics of amebic liver abscess in patients with or without human immunodeficiency virus

Amebic liver abscess (ALA) is the most common extra-intestinal amebiasis. This study was performed to review the clinical features of patients with amebic liver abscesses and compare them in Taiwanese patients with or without human immunodeficiency virus (HIV).

The medical charts of 27 inpatients with ALA treated at the Taipei Medical University Hospital, Taipei, Taiwan, were retrospectively analyzed. ALA was defined as positive findings of indirect hemagglutination test (IHA) and imaging study. Patients were divided into 2 groups according to their HIV infection status.

The most common clinical symptoms were fever (89.9%) and abdominal pain (81%). The mean white blood cell count in HIV-uninfected patients was significantly higher than in infected patients (17,830 +/- 4,722/microL vs 11,549 +/- 5,325/microL; p < 0.01). The aspartate aminotransferase levels were significantly lower in HIV-infected patients than in uninfected patients (85.7 +/- 59.1 IU/L vs 31.7 +/- 21.2 IU/L; p < 0.01). Three HIV-uninfected patients and 10 infected patients had IHA titer >1:1024 (p < 0.05). The duration of hospital stay was longer for HIV-uninfected patients than for infected patients (24.8 +/- 14.6 days vs 11.6 +/- 5.9 days; p <0.05).

HIV-infected patients with ALA had a more insidious onset of illness, significantly lower white cell count and liver enzymes, and shorter duration of hospital stay than uninfected patients. Physicians should be alert to ALA for early diagnosis and treatment.