LIVER-DISEASE ASSOCIATED WITH INFECTION B Y THE HUMAN-IMMUNODEFICIENCY-VIRUS - ANATOMOCLINICAL STUDY

Objective: To study the spectrum of liver disease in the infection by the human immunodeficiency virus (HIV) and to asses the usefulness and indications of liver biopsy. Patients: Fifty eight HIV seropositive p atients (48 intravenous drugs users) were prospectively studied by mea ns percutaneous liver biopsy, because of hepatic biological alteration s, hepatomegaly or fever of unknown origin. Results: Chronic hepatitis was the most common diagnosis, which was found in up to 20 patients ( 34%) (12 had chronic active hepatitis). Most of them were caused by he patitis C virus (90%). Hepatic granulomatosis was diagnosed in nine pa tients (15%), all of them among the subgroup of 19 patients (47%) stud ied because of fever of unknown origin. Granulomas were thought to be caused by mycobacteria in eight cases (seven tuberculosis, one Mycobac terium avium-intracellulare. Mycobacteria were isolated in culture in four patients whose histologic findings were inespecific. Other repres entative diagnosis were liver cirrhosis in eight patients, lymphoma in two, alcoholic hepatitis in one and candidiasic hepatitis in one. The diagnostic yield of liver biopsy was 79%. Conclusions: Liver biopsy i s a useful method in the diagnosis of these patients, specially if the y present with fever of unknown origen or hepatic biological alteratio ns. In this study chronic active hepatitis was the most common finding , while hepatic granulomatosis was so in patients with fever of unknow n origin.