HIV-Related hepatic disease: when and why to biopsy

Patients infected with HIV are susceptible to a variety of hepatic processes that are related to immunosuppression or are associated with the risk factors of homosexuality and parenteral drug use. These processes present in a myriad of ways including fever, right upper quadrant pain, and hepatomegaly, or simply as asymptomatic elevations of liver tests. Care of these patients demands systematic evaluation and treatment to ensure that morbidity and mortality are minimized and quality of life and medical care costs are optimized.