LAPAROSCOPIC AND HISTOLOGIC-FINDINGS IN PATIENTS WITH THE HUMAN-IMMUNODEFICIENCY-VIRUS

Hepatic dysfunction frequently develops in patients infected with the human immunodeficiency virus (HIV). This retrospective study was under taken to determine the laparoscopic and histologic findings in a group of HIV-seropositive patients with or without the acquired immune defi ciency syndrome (AIDS). Fifty-four patients, 44 with AIDS and 10 HIV-p ositive, underwent laparoscopic examination and visually guided biopsi es for the assessment of clinical or biochemical evidence of liver inj ury. Significant abnormalities were detected in 31/44 (70%) AIDS patie nts and 3/10 (30%) HIV-positive patients. Overall, specific laparoscop ic findings were described in 25/54 (46%). The most common findings we re peritoneal involvement, massive intra-abdominal adhesions, focal le sions of the liver or spleen, and diffuse nodularity of the liver; the se were usually related to opportunistic infections or neoplasms such as non-Hodgkin's lymphomas and Kaposi's sarcoma. No procedure-related deaths occurred. Laparoscopy is a safe and accurate method to detect u nderlying disease in a selected population of HIV-seropositive patient s.