DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20185370

Pattern of hepatobiliary involvement in HIV/AIDS patients: study in a tertiary care centre

Kamlesh Sharma, Vandana Sharma, Aradhana Singh, Ketki .

Abstract


Background: Diseases of hepatobiliary system is a major problem in patients with HIV infection. It has been estimated that approximately one third of the death of patients with HIV infection are in some way related to liver disease. While this is predominantly a reflection of the problems encountered in the setting of co-infection Hepatitis B or C, it is also a reflection of the hepatic injury in the form of hepatic steatosis, that can be due to antiretroviral therapy. There had been little work done on liver function tests in HIV patients without pre-existing liver disease like viral hepatitis, or alcoholic hepatitis. So, this study was designed to assess the pattern of liver function test derangement in HIV patients. Aims and objective was to study the different pattern of hepatobiliary involvement in HIV positive patients, and to gauge the extent of liver damage.

Methods: The study included 50 HIV positive patients coming to SMS hospital and Medical College, Jaipur, in medicine and HIV clinic of skin and VD department. Subjects having HIV test positive by ELISA, are included in this study. Other causes of liver function derangements were excluded from the study.

Results: Maximum number of the patients were in the age group of 23-32 years. Out of 50 cases studied, 41 (82 %) cases had abnormal liver function tests, while 9 (18%) had normal liver function tests. Most of the cases had liver function abnormalities, and most common abnormality was raised SGOT/SGPT.

Conclusions: Almost all types of liver function tests are found to be deranged in HIV patients. The pattern of hepatobiliary involvement varied from fatty liver, cholestasis to Toxic necrosis and granulomas.


Keywords


HIV positive patients, Liver function tests

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References


Rosenthal E, Poiree M, Pradier C, Perronne C, Salmon-Ceron D, Geffray L, et al. Mortality due to hepatitis C-related liver disease in HIV-infected patients in France (Mortavic 2001 study). Aids. 2003 Aug 15;17(12):1803-9.

Thio CL, Seaberg EC, Skolasky Jr R, Phair J, Visscher B, Muñoz A, et al. HIV-1, hepatitis B virus, and risk of liver-related mortality in the Multicenter Cohort Study (MACS). The Lancet. 2002 Dec 14;360(9349):1921-6.

Tedaldi EM, Baker RK, Moorman AC, Alzola CF, Furhrer J, McCabe RE, et al. Influence of coinfection with hepatitis C virus on morbidity and mortality due to human immunodeficiency virus infection in the era of highly active antiretroviral therapy. Clin Infec Dis. 2003 Feb 1;36(3):363-7.

Harrison’s Principle of Internal Medicine: HIV disease: AIDS and related disorders: Global pandemic, Joint United Nations Programme on HIV-AIDS. 15th ed. 1559:309.

Borges NE, Koppikar GV. Spectrum of liver disease in HIV infection. Indian J Gastroenterol. 1997;16(3):94-5.

Viriyavejakul P, Rojanasunan P, Viriyavejakul A, Punyarit P, Punpoowong B, Khachansaksumet V, et al. Opportunistic infections in the liver of HIV-infected patients in Thailand: a necropsy study. Tuberculosis. 2000;19:16-2.

Lonergan J, Behling C, Pfander H, Hassanein T, Mathews W. Hyperlactatemia and hepatic abnormalities in 10 HIV-infected patients receiving nucleoside analogue combination regimens. Clin Infect Dis. 2000;31:162-6.

Núñez M, González-Requena D, González-Lahoz J, Soriano V. Interactions between nevirapine plasma levels, chronic hepatitis C, and the development of liver toxicity in HIV-infected patients. AIDS research and human retroviruses. 2003 Mar 1;19(3):187-8.

Ghany M, Nagle JH. Approach to the patients with liver disease: Harrison’s Principles of Internal Medicine. 16th ed. 1808:282.

Wnuk AM. Liver damage in HIV infected patients patients: Medical science Monika. 2001;7(4):728-36.

Telegdy L. Szabo Z. Liver changes in HIV/AIDS. Orvosi Hetilap. 1999;140(15):811-4.

Trojan A, Kreuzer KA, Flury R, Schmid M, Schneider J, Schröder S. Liver changes in AIDS. Retrospective analysis of 227 autopsies of HIV-positive patients. Der Pathologe. 1998 May;19(3):194-200.

Kravchenko AV, Roslyĭ IM, Serebrovskaia LV, Shakhgil'dian VI, Serova VV, Tishkevich OA, et al. The etiological structure and characteristics of liver involvement in patients with HIV infection. Terapevticheskii Arkhiv. 1997;69(11):32-5.

Puoti M, Spinetti A, Ghezzi A, Donato F, Zaltron S, Putzolu V, et al. Mortality for liver disease in patients with HIV infection: a cohort study. Journal of acquired immune deficiency syndromes (1999). 2000 Jul;24(3):211-7.

Manfredi R. HIV disease, antiretroviral treatment and the liver. Recenti Progressi in Medicina. 2003;94(4):149-53.

Sud A, Wanchu A, Bambery P, Singh S, Chawla Y. Effect of hepatitis C virus coinfection on liver function of patients infected with HIV. Trop Gastroenterol: J Dig Dis Found. 1999;20(3):128-30.

Shahmanesh M, Cartledge J, Miller R. Lactic acidosis and abnormal liver function in advanced HIV disease. Sexually transmitted infections. 2002 Apr 1;78(2):139-42.

Pratt DS. Evaluation of liver functions: Principle of Internal Medicine. 16th ed. 1815:283.

Myers RP, Benhamou Y, Imbert-Bismut F, Thibault V, Bochet M, Charlotte F, et al. Serum biochemical markers accurately predict liver fibrosis in HIV and hepatitis C virus co-infected patients. Aids. 2003 Mar 28;17(5):721-5.

Rathi PM, Amarapurkar. Spectrum of liver disease in HIV infection. Ind J Gastroenterol. 1997;16(3):94-5.