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Liver biopsy pathology in human immunodeficiency virus infection
M Kennedy1, M O'Reilly, C J Bergin
1Department of Histopathology, St James's Hospital and Trinity College, Dublin, Ireland.
Insights
Liver biopsy revealed significant hepatic changes in human immunodeficiency virus (HIV) patients, identifying conditions like chronic hepatitis and cirrhosis. While useful for primary liver issues and unexplained fevers, it was less effective for opportunistic infections.
Area of Science:
- Hepatology
- Infectious Diseases
- Virology
Background:
- Human immunodeficiency virus (HIV) infection can affect the liver.
- Understanding hepatic manifestations in HIV patients is crucial for management.
- Liver biopsy is a diagnostic tool for various liver conditions.
Purpose of the Study:
- To investigate hepatic changes in HIV-infected individuals in Dublin.
- To evaluate the diagnostic utility of liver biopsy in this patient group.
Main Methods:
- Retrospective analysis of liver biopsy specimens from HIV patients.
- Correlation of histological findings with clinical data.
- Histological review of 39 biopsies from 36 patients.
Main Results:
- 86% of biopsies showed pathological changes.
- Non-specific changes were most common, followed by viral-induced chronic hepatitis (15 cases).
- Acute hepatitis (5 cases), cirrhosis (4 cases), and granulomas (5 cases) were also observed.
Conclusions:
- Liver biopsy effectively identified primary hepatic pathology in HIV patients.
- Biopsy aided in diagnosing causes of pyrexia of unknown origin (PUO).
- It was not effective in detecting opportunistic infections in the liver, despite their presence elsewhere.
Objectives:
To determine the hepatic changes in patients with human immunodeficiency virus (HIV) infection in Dublin and to assess the usefulness of liver biopsy in this condition.
Design:
A consecutive series of liver biopsies was examined retrospectively and correlated with clinical findings.
Methods:
A histological review was conducted of specimens from all patients who had undergone liver biopsy in a tertiary referral centre for HIV-infected patients in Dublin.
Results:
Thirty-nine liver biopsies were studied from 36 patients. Thirty-one (86%) showed pathological changes. Non-specific changes were most frequent, followed by viral-induced chronic hepatitis (15 cases). Acute hepatitis was documented in five and cirrhosis in four cases. Five biopsies performed for pyrexia of unknown origin (PUO) or suspected tuberculosis showed granulomas. Organisms were rarely identified (2) and bile duct changes were uncommon.
Conclusions:
Liver biopsy was useful in detecting primary hepatic pathology and, in some cases, the cause of PUO, but not useful in detecting opportunistic infections despite their known presence in other organs.
