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Hepatobiliary diseases in patients with AIDS: focus on AIDS cholangiopathy and gallbladder disease
1Division of Gastroenterology and Hepatology,University of Alabama at Birmingham, Ala., USA.
Diseases of the biliary tree and gallbladder are being described with increasing frequency among patients with the acquired immunodeficiency syndrome (AIDS). Despite the profound immunosuppressive therapy transplant recipients receive, these patients do not appear to be affected by these disorders; thus, human immunodeficiency virus (HIV)-infected patients appear to be uniquely susceptible. Most HIV-infected patients that develop cholangiopathy have severe immunodeficiency with CD4 lymphocyte counts <200/mm3. The objective of this review is to summarize the available literature on AIDS-cholangiopathy, focusing on its diagnosis and classification and to suggest an approach for its evaluation and its management.
Diseases of the biliary tree and gallbladder are being described with increasing frequency among patients with the acquired immunodeficiency syndrome (AIDS). Despite the profound immunosuppressive therapy transplant recipients receive, these patients do not appear to be affected by these disorders; thus, human immunodeficiency virus (HIV)-infected patients appear to be uniquely susceptible. Most HIV-infected patients that develop cholangiopathy have severe immunodeficiency with CD4 lymphocyte counts <200/mm3. The objective of this review is to summarize the available literature on AIDS-cholangiopathy, focusing on its diagnosis and classification and to suggest an approach for its evaluation and its management.