Liver enlargement associated with opportunistic infections in patients with human immunodeficiency virus infection.
OBJECTIVE
Liver disease is commonly present in human immunodeficiency virus (HIV) infection. The aim was to determine the frequency of liver enlargement and its association with opportunistic infections in patients with HIV infection.


METHODS
A total of 400 HIV-infected patients were investigated. Commercial kits (Ortho EIA; BioRad, ELISA) were used for detection of serum specific antibodies to HIV, hepatitis C virus, surface antigen of hepatitis B virus, and cytomegalovirus. Liver tissues were stained for various microorganisms. The electronic data base SPSS for Windows (version 10.0) was used for statistical analysis. A p <0.05 was considered significant.


RESULTS
Ultrasonographic screening revealed liver enlargement in 63.75% of HIV patients. In 40.7% the right lobe size varied from 140 mm to 160 mm. Of those with hepatomegaly, 60.7% had AIDS. Hepatitis C and B viruses and Mycobacterium tuberculosis were detected in 50%, 29% and 18% of patients, respectively. Histological changes were mostly non-specific. Liver pathology depended on the degree of cellular immune deficiency, particularly in patients with HBV co-infection. In a minority of patients (32.5%), the histology revealed granulomatous hepatitis. Liver function tests were abnormal in 46%.


CONCLUSIONS
Liver enlargement is common in HIV-infected patients mostly in association with hepatitis C and B viruses and Mycobacterium tuberculosis.
Terzic
Dragica
D
Clinic for Infectious Diseases, Clinical Center of Montenegro, Podgorica, Ljubljanska bb Podgorica, Montenegro. zodra@cg.yu
Brmbolic
Branko
B
Singer
Djordje
D
Dupanovic
Brankica
B
Korac
Milos
M
Selemovic
Dubravka
D
Svirtlih
Neda
N
Draskovic
Nenad
N
Mugosa
Boban
B
Boricic
Ivan
I
Terzic
Zoran
Z
D000293:Adolescent; D000328:Adult; D000368:Aged; D000914:Antibodies, Viral / Q000097:blood; D015984:Causality; D015897:Comorbidity; D003587:Cytomegalovirus / Q000276:immunology; D003586:Cytomegalovirus Infections / Q000097:blood / Q000453:epidemiology; D005260:Female; D006678:HIV / Q000276:immunology; D015658:HIV Infections / Q000097:blood / Q000453:epidemiology*; D016174:Hepacivirus / Q000276:immunology; D006509:Hepatitis B / Q000097:blood / Q000453:epidemiology; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006526:Hepatitis C / Q000097:blood / Q000453:epidemiology; D006529:Hepatomegaly / Q000097:blood / Q000000981:diagnostic imaging / Q000453:epidemiology*; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009894:Opportunistic Infections / Q000097:blood / Q000150:complications*; D012189:Retrospective Studies; D014376:Tuberculosis / Q000097:blood / Q000453:epidemiology; D014463:Ultrasonography; D055815:Young Adult
D000914:Antibodies, Viral; D006514:Hepatitis B Surface Antigens