title: Hepatic disease in patients with the acquired immune deficiency syndrome (AIDS).
abstract: The spectrum of liver disease in patients with acquired immune deficiency syndrome (AIDS) and the clinical impact of diagnostic percutaneous liver biopsy in this population were evaluated by a retrospective review of hepatic histology, clinical features and laboratory data in 85 patients (26 biopsies, 59 autopsies). Only 1 (3.8%) biopsy and 9 (15%) postmortem livers were histologically normal. Macrosteatosis and nonspecific portal inflammation were the most common histologic abnormalities. Intrahepatic AIDS-specific opportunistic infections or malignancies were detected in 42% of both biopsy and autopsy groups, with Mycobacterium avium-intracellulare the most frequent pathogen seen. Kaposi's sarcoma, although not detected on biopsy, was the most common postmortem AIDS-related hepatic finding. Intrahepatic lymphoma, cytomegalovirus hepatitis and hepatic mycoses were less frequently observed. In general, hepatic involvement represented part of a previously diagnosed, widely disseminated disease process, and liver biopsy led to new AIDS-specific diagnoses in only two patients. We conclude that while liver biopsy is a useful diagnostic tool in selected patients with AIDS, the information provided by biopsy rarely influences therapy or leads to improved survival.
authors.affiliation: Medicine Service, San Francisco General Hospital, California.
authors.forename: D J
authors.initials: DJ
authors.lastname: Schneiderman
authors.forename: D M
authors.initials: DM
authors.lastname: Arenson
authors.forename: J P
authors.initials: JP
authors.lastname: Cello
authors.forename: W
authors.initials: W
authors.lastname: Margaretten
authors.forename: T E
authors.initials: TE
authors.lastname: Weber
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000328:Adult; D001344:Autopsy; D001706:Biopsy; D003586:Cytomegalovirus Infections / Q000209:etiology; D005260:Female; D006801:Humans; D008099:Liver / Q000473:pathology; D008107:Liver Diseases / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000209:etiology / Q000473:pathology; D008297:Male; D009164:Mycobacterium Infections / Q000209:etiology; D009162:Mycobacterium avium; D012189:Retrospective Studies; D012514:Sarcoma, Kaposi / Q000209:etiology / Q000473:pathology