Liver Enlargement Associated with Opportunistic Infections in Patients with Human Immunodeficiency Virus Infection
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Dragica Terzic1, Branko Brmbolic2,
Djordje Jevtovic2 Brankica Dupanovic1, Milos
Korac1, Dubravka Selemovic2, Neda Svirtlih2,
Nenad Draskovic1, Boban Mugosa4, Ivan Boricic5,
Zoran Terzic3
1) Clinic for Infectious Diseases, Clinical Center of Montenegro,
Podgorica, Montenegro;
2) Institute for Infectious and Tropical Diseases, Clinical Center
of Serbia, Belgrade, Serbia;
3) Clinic for Surgery, Clinical Center of Montenegro, Podgorica,
Montenegro;
4) Institute for Public Health, Podgorica, Montenegro;
5) Institute for Pathology, Medical Faculty of Belgrade, Belgrade,
Serbia
Abstract
Background & Aim. Liver disease is commonly
present in human immunodeficiency virus (HIV) infection. The aim
was to determine the frequency of liver enlargement and its association
with opportunistic infections in patients with HIV infection.
Patients and methods. A total of 400 HIV-infected
patients were investigated. Commercial kits (Ortho EIA; BioRad,
ELISA) were used for detection of serum specific antibodies to
HIV, hepatitis C virus, surface antigen of hepatitis B virus,
and cytomegalovirus. Liver tissues were stained for various microorganisms.
The electronic data base SPSS for Windows (version 10.0) was used
for statistical analysis. A p <0.05 was considered significant.
Results. Ultrasonographic screening revealed
liver enlargement in 63.75% of HIV patients. In 40.7% the right
lobe size varied from 140 mm to 160 mm. Of those with hepatomegaly,
60.7% had AIDS. Hepatitis C and B viruses and Mycobacterium tuberculosis
were detected in 50%, 29% and 18% of patients, respectively. Histological
changes were mostly non-specific. Liver pathology depended on
the degree of cellular immune deficiency, particularly in patients
with HBV co-infection. In a minority of patients (32.5%), the
histology revealed granulomatous hepatitis. Liver function tests
were abnormal in 46%.
Conclusion. Liver enlargement is common in HIV-infected
patients mostly in association with hepatitis C and B viruses
and Mycobacterium tuberculosis.
Key words
Human immunodeficiency virus - hepatomegaly - hepatitis C virus
- hepatitis B virus - mycobacterium
tuberculosis.
