[Liver involvement in secondary infections in HIV-infected patients]

To determine spectrum and frequency of hepatic lesions, clinical, laboratory and morphological characteristics of hepatic pathology in secondary diseases in HIV-infected patients.

In 1991 to 2002 the authors observed 59 HIV-infected patients with hepatic affection caused by opportunistic infections and tumors. The examination included biochemical tests of blood, immunological tests, biopsies and tests of the autopsy material for CMVDNA, T. Gondii, M. Tuberculosis. Polymerase chain reaction, puncture biopsy of the liver, ultrasound investigation of the abdominal organs. 57 lethal outcomes were registered.

Hepatic lesion was of tuberculous origin in 42.4%, CMV--in 16.9%, toxoplasmic--in 6.8%. 3 patients had fungal infection. Cancer of the liver was diagnosed in 18.6%. Clinical picture in most of the examinees was not clear and did not correspond to morphological severity of the condition. Ultrasound detected hepatic lesions if they were caused by CMV infection, toxoplasmosis and malignant tumors. Biochemical parameters were changed moderately. Patients with CMV hepatitis showed significant rise in the activity of GGT and AP.

Apart from virus hepatitis B, C and D, the liver of HIV-infected patients got affected with tuberculosis, CMV-infection, toxoplasmosis, cancer. Hepatitis in HIV-infected subjects unrelated to viruses or medicines indicates a generalized disease, late stage of HIV-infection with a fall of the number of CD4-lymphocytes under 100 cells/microl.