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Liver and intrahepatic bile ducts-nontumor

Viral hepatitis

HIV (Human Immunodeficiency Virus)


Reviewers: Komal Arora, M.D. (see Reviewers page)
Revised: 9 May 2012, last major update May 2012
Copyright: (c) 2004-2012, PathologyOutlines.com, Inc.

General
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● Liver disease is most common non-AIDS-related cause of death among HIV+, accounting for 14%-18% of all deaths and almost half of deaths among hospitalized HIV+ patients (Clin Gastroenterol Hepatol 2010;8:1002, US Department of Veterans Affairs HIV/AIDS website)
● Often co-infection with atypical mycobacteria (often without granulomas at autopsy), Bartonella henselae (bacillary angiomatosis), CMV, Coccidiodes, Cryptococcus, Cryptosporidium (may affect biliary tree), Histoplasma, Pneumocystis
● Also higher incidence of lymphoma, Kaposiís sarcoma, peliosis hepatis
● High incidence of serologic infection with hepatitis B, although usually no significant liver disease
● May be associated with non-cirrhotic portal hypertension (Ann Hepatol 2009;8:390)

Micro description
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● Canalicular cholestasis; polarizable material in portal tracts of intravenous drug abusers
● Children may have bile duct damage and endothelialitis, with portal and lobular infiltrate, resembling graft versus host disease
● Usually no lymphocytes in portal tract due to leukopenia

Micro images
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Hepatic macrovesicular and microvesicular steatosis associated with symptomatic lactic acidosis syndrome, thought due to nucleoside analog reverse-transcriptase inhibitors

End of Liver and intrahepatic bile ducts-nontumor > Viral hepatitis > HIV (Human Immunodeficiency Virus)


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