Introduction: In India due to poor sanitary condition and a lower socioeconomic status amoebiasis is endemic and amoebic liver abscess accounts for 3-9% of all cases of amoebiasis. Amoebic liver abscess (ALA) is the commonest extra intestinal manifestation of amoebiasis.

Aim: The aim of this work is to study the various presentations of amoebic liver abscess and HIV correlation to find any change in the clinical and radiological profile of ALA in recent years and to compare with other studies.

Materials and Methods: This study is conducted prospectively over a period of 2 years from December 2015 to November 2017 in the department of General Medicine, Andhra Medical College and King George Hospital, Visakhapatnam, Andhra Pradesh.

Study Design: Observational study.

Sample Size: Eighty patients were the confirmed diagnosis of ALA are included in this study.

Study Subjects: All patients who fulfill the diagnostic criteria for amoebic liver abscess are included in the study.

Results: In the present study, the incidence of amoebic liver abscess in the year 2016 is estimated to be 0.58/1000/year of 61,732 patients admitted in King George Hospital, Visakhapatnam whereas the incidence of HIV positive with amoebic liver abscess in the year 2016 is only 0.08/1000/year. Among HIV patients ALA is more intense in presentation and treatment if challenging.

Discussion: The present study has shown that the patterns of ALA largely parallels what has been established previously in terms of age, sex, onset, risk factors, clinical manifestations, number, size and location of abscess, treatment modalities and prognosis with few modifications.

Conclusions: It is concluded that amoebic liver abscess is a treatable condition having a good prognosis if it is recognized early and treated appropriately particularly among HIV patients.

Keywords: ALA, HIV, Clinical, Radiological, study.

1. Seeto RK, Rockey DC. Amebic liver abscess: epidemiology, clinical features, and outcome. West J Med 1999;170:104-109.
2. Msltz G, Knauer CM. Amebic liver abscess: A 15-year experience. Am J Gastroenterol 1991;86:704-710.
3. Douglas G. Moore P Jr, Patterson M. A ten-year review of amebic abscess of the liver: 1959-1966. Am J Dig Dis 1968;13:709-717.
4. Katzenstein D, Rickerson V, Braude A. New concepts of amebic liver abscess derived from hepatic imaging, serodiagnosis, and hepatic enzymes in 67 consecutive cases in San Diego. Nedicine (Baltimore) 1982;61:237-246.
5. Akgun Y, Tacyildiz IH, Celik Y. Amebic liver abscess: Changing trends over 20 years. World J surg 1999;23:102-106.
6. Oh MD, Lee K, Kim E, et al. Amoebic liver abscess in HIV-infected patients. AIDS 2000;14:1872-1873.
7. Sharma MP, Sarin SK: Amoebic Liver Abscess in a North Indian Hospital-current trends. Brit J ClinPrac. 1987,41:789-93.
8. Wu KS, Tsai HC, Lee SS, et al. Comparison of clinical characteristics of amebic liver abscess in human immunodeficiency virus (HIV)-infected and non-HIV-infected patients. J Microbiollummunol Infect 2008;41:456.
9. Stanley SL Jr, Jackson TF, Foster L, Singh S. Longitudinal study of the antibody response to recombinant Entamoeba histolytica antigens in patients with amebic liver abscess. Am J Trop Med Hyg 1998;58;414.
10. Khanna S, Chaudhary D, Kumar A, Vij JC. Experience with aspiration in cases of amebic liver abscess in an endemic area. Eur J ClinMicrobiol Infect Dis 2005;24:428.
11. Sharma MP, Dasarathy S, Verma N, et al. Prognostic markers in amebic liver abscess: a prospective study. Am J Gastroenterol 1996; 91:2584.
12. Meng-Shuian Hsu, et al. Association between amebic liver abscess and Human Immunodeficiency Virus infection in Taiwanese subjects. BMC Infectious Diseases 2008.8:48.
13. Soumik Ghosh, Sourabh Sharma, A. K. Gadpayle, et al., “Clinical, Laboratory, and Management Prtofile in Patients of Liver Abscess from Northern India,” Journal of Tropical Medicine , vol. 2014, Article ID 142382, 8 pages,2014.
14. Mukhopdhyay M, Saha AK, Sarkar A, Mukherjee S. Amoebic liver abscess: presentation and complications. Indian Journal of Surgery 2012;72(1):37-41.
15. Mkkar RP, Sachdev GK, Malhotra V. Alcohol consumption, hepatic iron load and the risk of amoebic live abscess: a case control study. Internal Medicine. 2003;42(8):644-649.
16. Chuah S-K, Chang-Chien C-S, Sheen I-S, et al. The prognostic factors of severe amebic liver abscess: a retrospective study of 125 cases. The American Jounal of Tropical Medicine and Hygiene. 1992;46(4):398-402.
17. Yoo HM, Kim WH, Shin SK, Chun WH, Kang JK, Park IS. The changing patterns of liver abscess during the past 20 years: a study of 482 cases. Yonsei Medical Journal. 1993;34(4):340-351.
18. Hoque MI, Uddin MS, Sarker AR, Uddin MK-Mymensingh. Common presentation of amebic liver abscess – a study in a tertiary care hospital in Bangladesh. Med J – October 1, 2014; (4); 724-9.
19. Jha AK, Das G, Maitra S, Sengupta TK, Sen S. Management of large amoebic liver abscess—a comparative study of needle aspiration and catheter drainage. J Indian Med Assoc – January 1, 2012; 110 (1); 13-5.
20. P, H N Lakshmi, M Rathi, D Saini, R Saini, R Arya. A Prospective Study Of Liver Abscesses: Clinical Profile And Management Of 100 Cases Admitted In A Single Surgical Unit Of the SMS Hospital In Jaipur, India. The Internet Journal of Infectious Diseases. 2014 Volume 13 Number 1.
21. Ramani A, Ramani R, Kumar MS, Lkshkar BN, Kundae GN (1993) Ultrasound-guided needle aspiration of amoebic liver abscess. Postgrad Med J 69(811):381-383.
22. Viroj Wiwanitkit. A note on clinical presentations of amebic liver abscess: an overview from 62 Thai patients. BMC Family Practice 2002,3
23. Hsu MS, Hsieh SM, Chen MY, Hung CC, Chang SC, Association between amebic liver abscess and human immune-deficiency virus infection in Taiwaness subjects. BMC Inf Dis. 2008;48-52
24. Chen KJ, Yang CH, Lin YC, Liu HY, Liao ST, Lee YJ. Characteristics of amebic liver abscess in patients with or without human immunodeficiency virus. J Microbiol-lmmunol Infect. 2009 Dec;42(6):500-4.
25. Jessurun J, Barron-Rodriguez LP, Fernandez-Tinoco G, Hernandez- Avila M The prevalence of invasive amebiasis is not increased in patients with AIDS. AIDS 1992;6:307-9 doi: 10.1097/00002030-199203000-00007.
26. Hung CC, Chen PJ, Hsieh SM, Wrong JM, Fang CT, Chang SC, et al. Invasive qamoebiases: an emerging parasitic disease in patients infect3ed with HIV in an area endemic for amoebic infection. AIDS 1999;13:2421-8doi: 10.1097/00002030-199912030-00014.

Dr K.Kodanda Rao M.S (G.S)

Faculty, Dept of General Surgery, Gitam Institute of Medical Sciences and Research, Gitam Deemed to be University, Visakhapatnam, Andhra Pradesh, India