[The spectrum of liver disease in infection by the human immunodeficiency virus: a study of 50 liver biopsies].
BACKGROUND
The patients with human immunodeficiency virus (HIV) infection have hepatic abnormalities due to infective, neoplastic and toxic disorders. The aim of the present study was to describe the spectrum of liver disease in the HIV infection and to establish the usefulness and indications of hepatic biopsy.


METHODS
The hepatic biopsies prospectively carried out in 50 patients infected by HIV with abnormal hepatic biochemical parameters, fever of unknown origin or space occupying lesions were evaluated.


RESULTS
Hepatic granulomatosis was found in 37 patients (74%). In 15 (30%) the culture in Löwenstein medium was positive. The strains were typified as Mycobacterium tuberculosis in 14. This finding took place in 8 out of 18 biopsies carried out because of fever of unknown origin (FUO) (44%). The rate of granulomatosis due to mycobacteria was 40%. Other diagnoses were steatosis in 22 patients, chronic active hepatitis in 10, chronic lobular hepatitis in 3, infiltration by Hodgkin's lymphoma in one and metastatic invasion by non-differentiated carcinoma in one. Hepatic biopsy was diagnostic in 8 out of 18 carried out for FUO (44%) and in 24 out of 30 carried out for abnormal hepatic biochemical parameters (80%).


CONCLUSIONS
In the evaluated patients with HIV infection, hepatic granulomatosis was the most common finding and was due to mycobacteria in 40%. Hepatic steatosis and chronic active and lobular hepatitis were the most common causes of abnormal hepatic biochemical parameters. Considering the high yield of hepatic biopsy, the authors think that it should be carried out in patients with HIV infection and FUO or unexplained abnormal hepatic biochemical parameters.
Servicio de Aparato Digestivo, Universidad Complutense, Madrid.
P
P
Escartín Muñoz-Ortiz
J A
JA
López G-Asenjo
C
C
García González
V
V
Roca Arbonés
C
C
Taxonera Samsó
R
R
Pieltain Alvarez-Arenas
M
M
Díaz-Rubio
D000328:Adult; D002908:Chronic Disease; D005260:Female; D005335:Fever of Unknown Origin / Q000209:etiology; D015658:HIV Infections / Q000150:complications*; D006505:Hepatitis / Q000209:etiology; D006801:Humans; D008107:Liver Diseases / Q000209:etiology* / Q000382:microbiology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009164:Mycobacterium Infections / Q000209:etiology; D011446:Prospective Studies
El espectro de la hepatopatía en la infección por el virus de la inmunodeficiencia humana: estudio de 50 biopsias hepáticas.