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To assess the possible influence of human immunodeficiency virus type 1 (HIV-1) infection on the clinical course of acute hepatitis A virus (HAV) infection, 15 HIV-1–infected homosexual men and 15 non—HIV-infected age-matched subjects were compared. HAV load was higher in HIV-1–infected than in non—HIV-infected patients (P < .001). Duration of viremia in HIV-1–infected patients (median, 53 days) was significantly (P < .05) longer than in non—HIV-infected patients (median, 22 days). HIV-1–infected patients had lower elevations in alanine aminotransferase levels than did non—HIV-infected patients (P < .01) but had higher elevations in alkaline phosphatase levels than did non—HIV-infected patients (P < .001). Some HIV-1–infected patients still had HAV viremia when clinical symptoms had disappeared and alanine aminotransferase levels had returned to normal (60–90 days after the onset of symptoms). HIV-1 infection was associated with prolongation of HAV viremia, which might cause a long-lasting outbreak of HAV infection in HIV-1–infected homosexual men.