[Hepatic involvement in HIV 1 virus infection]

One hundred consecutive patients with serum antibodies against HIV 1 were evaluated for the prevalence and the type of liver injury. According to the CDC classification, 16 patients belonged to group II (asymptomatic patients), 47 to group III (persistent generalized lymphadenopathy) and 37 to group IV (11 constitutional disease, 19 secondary infectious diseases, 5 secondary cancers, one chronic lymphoid interstitial pneumonitis and one visceral leishmaniasis). Liver histology was studied in 32 patients. Clinical, biological and histologic abnormalities were assessed according to the clinical group and to the number of T4 lymphocytes. The prevalence of HBV infection was determined by HBV DNA and monoclonal antibodies. Clinical hepatic abnormalities were rare (13 p. 100) and no difference was found between groups. Transaminases or GGT activities were elevated in 60 p. 100 of all cases. Serum GGT activity was higher and serum albumin lower in patients in group IV. HBV infection markers were less frequently found in patients with opportunistic infection (74 p. 100) than in asymptomatic patients (100 p. 100; p less than 0.05). Prevalence of serum HBsAg detected by poly- or monoclonal antibodies was very high (29 p. 100) in all clinical groups. Prevalence of serum HBsAg detected only by monoclonal antibodies (10 p. 100) suggest infection of these patients by an HBV variant. Of the 32 patients undergoing liver histology, only 5 (16 p. 100) had signs of activity. There was no association between clinical or histologic signs and the number of T4 lymphocytes per ml. Alkaline phosphatase, ASAT and GGT activities were higher and serum albumin lower in patients with less than 200 T4 lymphocytes per ml.