[Hepatic changes in patients with isolated immunodeficiency virus infection and AIDS]

The aim of the present study was to describe the spectrum of liver disease in isolated infection by the human immunodeficiency virus and in the acquired immunodeficiency syndrome as well as evaluate whether clinical and/or biological data exist to permit specific diagnosis in liver biopsy.

Liver biopsy was performed in 39 patients with the human immunodeficiency virus (34 via parenteral drug addicts), 22 of whom had established acquired immunodeficiency syndrome.

In 29 cases (74%) a specific histologic diagnosis was obtained with the changes most frequently found being the presence of granulomas (11 patients), mainly in patients with stablished AIDS, and chronic active hepatitis non A non B (10 patients), specially in the cases with isolated infection by the human immunodeficiency virus. Obtaining of a specific diagnosis was associated with an increase in GOT and a decrease of the CD4 lymphocytes and the CD4/CD8 quotient (p = 0.002 in all cases). The existence of established AIDS or prolonged fever was associated with the finding of hepatic granulomas (p = 0.02 and p = 0.002, respectively). The increase in GPT, the absence of stablished AIDS and the absence of prolonged fever was associated to the presence of chronic active hepatitis (p = 0.01, p = 0.002 and p = 0.0002, respectively).

In patients with infection by the human immunodeficiency virus liver biopsy provides diagnostic information in a high percentage of cases. The presence of established AIDS, prolonged fever, and hypertransaminasemia may point towards possible histologic diagnosis.