Document 0487
 DOCN  M9650487
 TI    Liver biopsy findings in 501 patients infected with human
       immunodeficiency virus (HIV).
 DT    9605
 AU    Poles MA; Dieterich DT; Schwarz ED; Weinshel EH; Lew EA; Lew R; Scholes
       JV; New York University Medical Center, NY 10016, USA.
 SO    J Acquir Immune Defic Syndr Hum Retrovirol. 1996 Feb 1;11(2):170-7.
       Unique Identifier : AIDSLINE MED/96147317
 AB    Patients infected with human immunodeficiency virus (HIV) are at risk
       for a variety of liver diseases. We undertook a retrospective study of
       501 HIV-seropositive patients to assess the yield of percutaneous liver
       biopsy. The most common indications for liver biopsy were liver test
       abnormalities (89.5%), fever for 2 weeks (71.9%), and hepatomegaly
       (52.0%). The most common biopsy-derived diagnosis was Mycobacterium
       avium complex (MAC), seen in 87 (17.4%) biopsies. Mycobacterium
       tuberculosis was found in 13 biopsies (2.6%). In 28 biopsies (5.6%)
       mycobacteria was seen, but speciation of the organism was not possible.
       Chronic active viral hepatitis was seen in 60 biopsies (12.0%).
       Opportunistic hepatic infection from other organisms was found in 14
       biopsies (2.8%). The most common neoplasm was lymphoma, which was seen
       in 12 biopsies (2.4%). MAC infection of the liver was associated with
       elevated alkaline phosphatase (p = 0.01). Among patients with fever for
       2 weeks after an extensive negative workup including bone marrow biopsy,
       58.2% had a diagnosis by liver biopsy. Overall, 64.3% of liver biopsies
       yielded a histopathological diagnosis, 45.7% of which were potentially
       treatable. We could not evaluate whether liver biopsy had a positive
       effect on patient outcome and survival, nor did we attempt to prove that
       liver biopsy resulted in a change in treatment or a change in
       preprocedure clinical diagnosis. Thus, questions about the efficacy of
       liver biopsy cannot be answered. Liver biopsy may be a helpful
       diagnostic tool in HIV-positive patients with fever, liver test
       abnormalities or hepatomegaly.
 DE    Adolescence  Adult  Aged  Biopsy, Needle  Child  Child, Preschool  CD4
       Lymphocyte Count  CD4-Positive T-Lymphocytes/IMMUNOLOGY  Female
       Hepatomegaly  Human  HIV Infections/*COMPLICATIONS/IMMUNOLOGY/PATHOLOGY
       HIV Seropositivity/COMPLICATIONS  *HIV-1  Infant  Liver/*PATHOLOGY
       Liver Diseases/*DIAGNOSIS/MICROBIOLOGY/PATHOLOGY  Liver Function Tests
       Male  Middle Age  Retrospective Studies  JOURNAL ARTICLE

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