[Hepatic disease associated with human immunodeficiency virus infection: anatomo-clinical study]

To study the spectrum of liver disease in the infection by the human immunodeficiency virus (HIV) and to assess the usefulness and indications of liver biopsy.

Fifty eight HIV seropositive patients (48 intravenous drugs users) were prospectively studied by means percutaneous liver biopsy, because of hepatic biological alterations, hepatomegaly or fever of unknown origin.

Chronic hepatitis was the most common diagnosis, which was found in up to 20 patients (34%) (12 had chronic active hepatitis). Most of them were caused by hepatitis C virus (90%). Hepatic granulomatosis was diagnosed in nine patients (15%), all of them among the subgroup of 19 patients (47%) studied because of fever of unknown origin. Granulomas were thought to be caused by mycobacteria in eight cases (seven tuberculosis, one Mycobacterium avium-intracellulare. Mycobacteria were isolated in culture in four patients whose histologic findings were inspecific. Other representative diagnosis were liver cirrhosis in eight patients, lymphoma in two, alcoholic hepatitis in one and candidiasic hepatitis in one. The diagnostic yield of liver biopsy was 79%.

Liver biopsy is a useful method in the diagnosis of these patients, specially if they present with fever of unknown origin or hepatic biological alterations. In this study chronic active hepatitis was the most common finding, while hepatic granulomatosis was so in patients with fever of unknown origin.