Liver biopsy findings in 501 patients infected with human immunodeficiency virus (HIV).

Important note: Information in this article was accurate in 1996. The state of the art may have changed since the publication date.

Liver biopsy findings in 501 patients infected with human immunodeficiency virus (HIV).

J Acquir Immune Defic Syndr Hum Retrovirol. 1996 Feb 1;11(2):170-7. Unique Identifier : AIDSLINE MED/96147317
Poles MA; Dieterich DT; Schwarz ED; Weinshel EH; Lew EA; Lew R; Scholes JV; New York University Medical Center, NY 10016, USA.

Abstract: Patients infected with human immunodeficiency virus (HIV) are at risk for a variety of liver diseases. We undertook a retrospective study of 501 HIV-seropositive patients to assess the yield of percutaneous liver biopsy. The most common indications for liver biopsy were liver test abnormalities (89.5%), fever for 2 weeks (71.9%), and hepatomegaly (52.0%). The most common biopsy-derived diagnosis was Mycobacterium avium complex (MAC), seen in 87 (17.4%) biopsies. Mycobacterium tuberculosis was found in 13 biopsies (2.6%). In 28 biopsies (5.6%) mycobacteria was seen, but speciation of the organism was not possible. Chronic active viral hepatitis was seen in 60 biopsies (12.0%). Opportunistic hepatic infection from other organisms was found in 14 biopsies (2.8%). The most common neoplasm was lymphoma, which was seen in 12 biopsies (2.4%). MAC infection of the liver was associated with elevated alkaline phosphatase (p = 0.01). Among patients with fever for 2 weeks after an extensive negative workup including bone marrow biopsy, 58.2% had a diagnosis by liver biopsy. Overall, 64.3% of liver biopsies yielded a histopathological diagnosis, 45.7% of which were potentially treatable. We could not evaluate whether liver biopsy had a positive effect on patient outcome and survival, nor did we attempt to prove that liver biopsy resulted in a change in treatment or a change in preprocedure clinical diagnosis. Thus, questions about the efficacy of liver biopsy cannot be answered. Liver biopsy may be a helpful diagnostic tool in HIV-positive patients with fever, liver test abnormalities or hepatomegaly.

Keywords: Adolescence Adult Aged Biopsy, Needle Child Child, Preschool CD4 Lymphocyte Count CD4-Positive T-Lymphocytes/IMMUNOLOGY Female Hepatomegaly Human HIV Infections/*COMPLICATIONS/IMMUNOLOGY/PATHOLOGY HIV Seropositivity/COMPLICATIONS *HIV-1 Infant Liver/*PATHOLOGY Liver Diseases/*DIAGNOSIS/MICROBIOLOGY/PATHOLOGY Liver Function Tests Male Middle Age Retrospective Studies JOURNAL ARTICLE
960530
M9651032

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