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AIDS-related cholangitis: diagnostic features and course in 15 patients
H Bouche1, C Housset, J L Dumont
1Unité d'Hépatologie, Hôpital Laënnec, Paris, France.
Journal of Hepatology
|January 1, 1993
Summary
Cholangitis in human immunodeficiency virus (HIV)-infected patients often presents with abdominal pain and cholestasis. Survival is poor, but endoscopic sphincterotomy can relieve pain.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Hepatology
Background:
- Cholangitis is a known complication in patients with acquired immune deficiency syndrome (AIDS).
- Limited data exists on cholangitis specifically in human immunodeficiency virus (HIV)-infected individuals.
Purpose of the Study:
- To describe the clinical features, diagnostic findings, and outcomes of cholangitis in HIV-infected patients.
- To evaluate the role of endoscopic retrograde cholangiopancreatography (ERCP) in diagnosis and management.
Main Methods:
- Retrospective review of 15 HIV-infected patients with cholangitis.
- Analysis of clinical presentation, diagnostic investigations (ultrasonography, ERCP), microbiological findings, and outcomes.
- Assessment of the impact of endoscopic sphincterotomy.
Main Results:
- Cholangitis was the initial manifestation of AIDS/HIV in 27% of patients.
- Common symptoms included abdominal pain (73%) and cholestasis (100%).
- Cryptosporidium (57%), CMV (28%), and Microsporidia (7%) were identified pathogens. Twelve-month survival was 14%.
Conclusions:
- Cholangitis in HIV patients is associated with significant morbidity and mortality, often linked to opportunistic infections.
- ERCP is crucial for diagnosis and offers therapeutic benefits, particularly for papillary stenosis.
- Endoscopic sphincterotomy effectively alleviates pain, but further evaluation of medical treatments is warranted.