LIVER PATHOLOGY IN AIDS - RETROSPECTIVE A NALYSIS OF 227 AUTOPSIES OFHIV PATIENTS

In a retrospective study of a 12-year period (1981-1992) liver histolo gy was analyzed in 227 autopsied patients infected with the human immu nodeficiency virus. Normal histology could only be documented in 29 pa tients (13%). In the majority of cases (56%) uncharacteristic changes were seen such as steatosis (34%), hemosiderosis (10%) or non-specific reactive hepatitis (7%). The finding of hepatic peliosis obtained in 4 patients was not associated with inflammatory liver changes, especia lly infections from Rocha-limaea. Within a wide range of opportunistic infections recorded in 50 patients (22%), hepatitis caused by Cytomeg alovirus (8%), Toxoplasma gondii (5%), leishmania donovani (1%), Crypt ococcus neoformans and Pneumocystis carinii (each 0.5%) was diagnosed. Among 16 cases (7%) of mycobacterial liver infections typical mycobac teria were found in two patients and atypical mycobacteria in 14 patie nts, respectively. In 23 patients (10%) chronic viral hepatitis, cause d by HBV (7%) or HCV infections (3%), respectively,was observed. Hepat itis was typed as mild only in each 5 patients with HBV or HCV infecti on, whereas the remaining cases showed a transition towards cirrhosis. Two patients with HBV-associated cirrhosis developed hepatocellular c arcinoma. The remaining 32 malignant liver tumors represented secondar y neoplasms, including 13 cases of non-Hodgkin's lymphomas.