Agranulocytosis during an acute episode of hepatitis B in an HIV-positive patient

BACKGROUND: During the course of acute hepatitis B, hematology disorders ar e common though they are generally mild and occur early. Agranulocytosis is exceptional and occurs late in the disease course. CASE REPORT: We report a case of agranulocytosis which developed 3 weeks af ter onset of acute hepatitis B in an HIV-positive patient. Peripheral and c entral hematological disorders led to the diagnosis. Agranulocytosis develo ped during the cytolytic phase of the primary hepatitis B infection and reg ressed after administration of hematopoietic growth factors. DISCUSSION: It is sometimes difficult to establish the causal effect of hep atitis B in the development of agranulocytosis in patients with an HIV co-i nfection who are on a multiple drug regimen and subject to multiple bacteri al, Viral or parasite infections.