# title
Diagnosis and Treatment of Acute-on-Chronic Liver Failure Caused by HIV/HBV Co-infection: A Case Report

# abstract
Introduction: By analyzing the diagnosis and treatment process of a case of acute-on-chronic liver failure (ACLF) caused by acquired immunodeficiency syndrome (AIDS) combined with chronic hepatitis B in the infection department in 2023, we evaluated whether human immunodeficiency virus (HIV) had an impact on the progression of ACLF, whether stopping oral antiretroviral therapy (ART) led to the accelerated progression of ACLF, and explored the factors of liver failure in the case of dual HIV and hepatitis B virus (HBV) infection. Case Presentation: The patient was a 39-year-old bachelor/unmarried male. There is no history of intravenous drug use, a history of HBV infection, or long-term alcohol consumption. In 2017, the patient was diagnosed with HIV infection and began taking oral ART antiviral medication. Unfortunately, the patient stopped taking the medication on his own, which led to cirrhosis and an enlarged spleen during the reexamination in February 2023. The ART treatment was resumed in June 2023. In August 2023, due to consciousness disorders after vomiting blood, the patient sought treatment at a local hospital and underwent endoscopic hemostasis in the emergency department. Subsequently, the patient suffered from worsening liver function damage, persistent jaundice, progressive ascites, refractory spontaneous peritonitis, intermittent consciousness disorders, and ultimately died from hemorrhagic shock caused by sudden upper gastrointestinal bleeding. Conclusions: Although the HIV virus is not inherently hepatotropic and does not cause liver cell damage, co-infection with HIV/HBV can accelerate the progression from hepatitis to cirrhosis, resulting in a considerably higher mortality rate among these patients compared to those with chronic hepatitis B alone. Therefore, further research is essential to elucidate the specific relationship between the two.