[HIV infection: findings in liver and bile ducts].

Abstract

Gastrointestinal diseases in HIV-infected patients mainly affect the bowel, the oesophagus, and the liver. Most of the hepatic diseases are due to opportunistic infections and associated to AIDS. In the advanced AIDS disease Mycobacterium avium intracellulare is the most frequent bacterial infections agent. Mycobacterium tuberculosis is often diagnosed in less immunocompromised patients. Viral hepatitis (A, B, C, D) is more often diagnosed in HIV-infected patients than in non-infected controls. Non-Hodgkin's lymphoma of the liver is a relatively frequent tumour in HIV-infected patients. Kaposi's sarcoma may also affect the liver. Infections with the cytomegalovirus or cryptococci mainly affect the biliary system causing acalculous cholecystitis or secondary sclerosing cholangitis. In addition to clinical and laboratory diagnostics sonographic and computer tomographic examinations are important. The diagnostic power of sonographic and computer tomographic examinations can be increased by guided biopsies. Biliary diseases can be diagnosed by retrograde endoscopic diagnostic investigations (ERC, ERCP). This overview resumes the most important diagnostic and differential diagnostic data in HIV-associated liver and biliary tract diseases.