CHOLECYSTECTOMY IN PATIENTS WITH AIDS - CLINICOPATHOLOGICAL CORRELATIONS IN 107 CASES

The etiologic and clinical features of cholecystitis in infection due to human immunodeficiency virus (HIV) were studied retrospectively. Th e charts and histopathologic specimens of 136 HIV-infected patients wh o underwent cholecystectomy between February 1987 and May 1993 at a la rge tertiary care center were reviewed. Opportunistic pathogens infect ing the 107 patients with AIDS included microsporidia (eight cases-Ent erocytozoon bieneusi in six and Septata intestinalis in two); cytomega lovirus alone (six cases); Cryptosporidium alone (eight cases); cytome galovirus plus Cryptosporidium (15 cases); and Pneumocystis carinii an d Isospora belli (one case each). In addition, histopathologic changes characteristic of Kaposi's sarcoma were seen in one case. Thirty-eigh t patients with AIDS had acalculous cholecystitis for which no etiolog ic agent was found. Twenty-eight AIDS patients had cholelithiasis, six with coexistent opportunistic gallbladder infection, In the 107 AIDS patients, no specific symptom was found to be predictive of opportunis tic infection of the gallbladder, but such infection was significantly associated with an abnormal abdominal ultrasound (P = .017) and with nonvisualization of the gallbladder by radionucleotide biliary scan (P < .001).