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AIDS-related cholangiopathy

Critical analysis of a prospective series of 26 patients

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Abstract

Several types of biliary tract abnormality of undertermined origin have been described among AIDS patients. The aims of this study are (1) to evaluate whether biliary tree involvement is in fact one or several homogeneous morphological entities, (2) to specify the role of CMV orCryptosporidium sp. infection, and (3) to evaluate the possible efficacy of treatment. Since ultrasound had revealed abnormality in the biliary tree, 26 consecutive AIDS patients underwent cholangiography. Cholangiograms enabled us to distinguish between two types of biliary tract involvement: (1) gradual and regular stenosis of the terminal portion of the common bile duct associated with dilation but without irregularity of the intrahepatic biliary ducts was present in 27% of our cases, and (2) distal stenosis of the extrahepatic biliary ducts combined with diffuse irregularity of the caliber of the intrahepatic bile ducts was present in 73% of our cases. Concomitant infection by CMV orCryptosporidium sp. was significantly more frequent when intrahepatic duct irregularities were present (94%) than when absent (14%,P<0.001). Anti-CMV treatment and sphincterotomy were unsuccessful in treating anomalies of the intrahepatic biliary tract. Conversely, sphincterotomy caused rapid and lasting disappearance of pain in all our patients. In conclusion, biliary tract involvement in AIDS patients is of two types. CMV infection and infection byCryptosporidium sp. are most frequent when the large intrahepatic ducts are implicated.

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Authors and Affiliations

  1. Service d'Hépato-Gastroenterologie, Groupe Hospitalier Pitié-Salpétrière, 47-83 boulevard de l'Hôpital, 75651, Paris Cédex 13, France

    Yves Benhamou MD, Eric Caumes MD, Yves Gerosa MD, Jean François Cadranel MD, Elisabeth Dohin MD, Christine Katlama MD, Paul Amouyal MD, Jean Marc Canard MD, Nabih Azar MD, Catherine Hoang MD, Yves Le Charpentier MD, Marc Gentilini MD, Pierre Opolon MD & Dominique Valla MD

  2. Service des Maladies Tropicales et Parasitaires, Groupe Hospitalier Pitié-Salpétrière, 47-83 boulevard de l'Hôpital, 75651, Paris Cédex 13, France

    Yves Benhamou MD, Eric Caumes MD, Yves Gerosa MD, Jean François Cadranel MD, Elisabeth Dohin MD, Christine Katlama MD, Paul Amouyal MD, Jean Marc Canard MD, Nabih Azar MD, Catherine Hoang MD, Yves Le Charpentier MD, Marc Gentilini MD, Pierre Opolon MD & Dominique Valla MD

  3. Laboratoire Central d'Anatomopathologie, Groupe Hospitalier Pitié-Salpétrière, 47-83 boulevard de l'Hôpital, 75651, Paris Cédex 13, France

    Yves Benhamou MD, Eric Caumes MD, Yves Gerosa MD, Jean François Cadranel MD, Elisabeth Dohin MD, Christine Katlama MD, Paul Amouyal MD, Jean Marc Canard MD, Nabih Azar MD, Catherine Hoang MD, Yves Le Charpentier MD, Marc Gentilini MD, Pierre Opolon MD & Dominique Valla MD

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  1. Yves Benhamou MD
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  2. Eric Caumes MD
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  3. Yves Gerosa MD
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  6. Christine Katlama MD
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  7. Paul Amouyal MD
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  8. Jean Marc Canard MD
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  9. Nabih Azar MD
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  10. Catherine Hoang MD
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  14. Dominique Valla MD
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Benhamou, Y., Caumes, E., Gerosa, Y. et al. AIDS-related cholangiopathy. Digest Dis Sci 38, 1113–1118 (1993). https://doi.org/10.1007/BF01295729

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  • DOI: https://doi.org/10.1007/BF01295729

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