AIDS cholangiopathy

AIDS cholangiopathy refers to an acalculous, secondary opportunistic cholangitis that occurs in AIDS patients as result of immunosuppression. 

Pathology

Characterised by multiple irregular narrowings essentially indistinguishable from primary sclerosing cholangitis (PSC). There are four pathological patterns 

  • combination of sclerosing cholangitis and papillary stenosis (50%)
  • isolated intrahepatic sclerosing cholangitis–like appearance (20%)
  • isolated papillary stenosis (15%)
  • long-segment extrahepatic duct stricture +/- concurrent intrahepatic disease (15%)
Aetiology

No definite organism is identified in up to half of patients. It typically affects patients with low CD4 counts (<135/mm3). Postulated causative organisms include:

  • cytomegalovirus (CMV)
  • herpes simplex virus (HSV)
  • Cryptosporidium parvum
  • Microsporidium
  • Mycobacterium avium complex

Differential diagnosis


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Article Information

rID: 817
Section: Pathology
Tags: refs, cases
Synonyms or Alternate Spellings:
  • AIDS related cholangitis
  • Acquired immunodeficiency syndrome (AIDS) cholangiopathy
  • HIV cholangiopathy

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