Emerging and stirring Amoebic liver abscess in HIV seropositive men who have sex with men in South-Eastern China.

Amebic liver abscess (ALA) is rare in Chinese population due to dietary habit. Nine Chinese HIV-seropositive men who have sex with men (MSM) with occurrence of amebic liver abscess (ALA) was retrospectively studied. Six participants had concurrent HIV/Syphilis and two had HIV/HCV. Symptoms primarily included fever, abdominal discomfort, and diarrhea. All participants showed intrahepatic abscesses, mainly in liver segments 6, 7, and 8, while two had additional extrahepatic amebic abscesses. Those with CD4 count < 100 cells/μL exhibited multiple and larger liver abscesses. Metagenomic Next-Generation Sequencing (mNGS) conclusively revealed Entamoeba histolytica despite bacterial culture and smear tests' negative results. All affected individuals were treated with percutaneous catheter drainage and metronidazole for at least 10 days. In summary, HIV-positive MSM are prone to develop ALA, and CD4 count < 100 cells/μL is a risk for occurrence of multiple and larger ALA. The optimal ALA treatment course for ALA remains dabatable.