Title:Non-cirrhotic Portal Hypertension Associated with Didanosine and Streptococcus agalactiae Infection: A Case Report
VOLUME: 11 ISSUE: 2
Author(s):Vesna Turkulov, Maja Ruzic, Dajana Lendak, Daniela Maric, Snezana Brkic and Ludovico Abenavoli
Affiliation:Department of Health Sciences, University “Magna Græcia”, Viale Europa, 88100, Catanzaro, Italy.
Keywords:Antiretroviral therapy, ascites, didanosine, human immunodeficiency virus, non-cirrhotic portal hypertension,
Streptococcus agalactiae.
Abstract:Background: Non-Cirrhotic Portal Hypertension (NCPH) is a rare but potentially fatal liver
disorder described in patients treated with anti-retroviral therapy for Human Immunodeficiency Virus
(HIV). In particular, the most important predisposing factor to its development has been identified as
prolonged exposure to Didanosine (ddI). The clinical entity of NCPH is characterized by an increase
in portal pressure due to pre- or intra-hepatic causes, in absence of liver cirrhosis. However, the exact
pathogenesis remains poorly understood, and due to its rarity, the diagnosis is often delayed.
Objective: We herein report a case in which ddI administration, with concomitant spontaneous bacterial peritonitis by
Streptococcus agalactiae, has induced NCPH in a HIV male patient.
Conclusion: NPCH should be suspected when HIV patient with an history of ddI treatment presents liver
decompensation.
