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AIDS Cholangiopathy

By

Christina C. Lindenmeyer

, MD, Cleveland Clinic

Last full review/revision Sep 2021| Content last modified Sep 2021
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AIDS cholangiopathy is biliary obstruction secondary to biliary tract strictures caused by various opportunistic infections.

Diagnosis of AIDS Cholangiopathy

  • Usually ultrasonography and endoscopic retrograde cholangiopancreatography (ERCP)

Imaging Imaging Tests of the Liver and Gallbladder Imaging is essential for accurately diagnosing biliary tract disorders and is important for detecting focal liver lesions (eg, abscess, tumor). It is limited in detecting and diagnosing diffuse... read more Imaging Tests of the Liver and Gallbladder usually begins with ultrasonography, which is noninvasive and very accurate (> 95%). However, ERCP is usually necessary. ERCP provides the diagnosis, enables clinicians to take a sample for small-bowel biopsy for identification of the causative organism, and provides a therapeutic opportunity to relieve strictures. CT and magnetic resonance cholangiopancreatography likely have supportive roles.

Treatment of AIDS Cholangiopathy

  • Endoscopic procedures

Endoscopic sphincterotomy, often done during endoscopic retrograde cholangiopancreatography, can markedly relieve pain, jaundice Jaundice Jaundice is a yellowish discoloration of the skin and mucous membranes caused by hyperbilirubinemia. Jaundice becomes visible when the bilirubin level is about 2 to 3 mg/dL (34 to 51 micromol/L)... read more Jaundice , and cholangitis Choledocholithiasis and Cholangitis Choledocholithiasis is the presence of stones in bile ducts; the stones can form in the gallbladder or in the ducts themselves. These stones cause biliary colic, biliary obstruction, gallstone... read more in patients with papillary stenosis. Isolated or dominant strictures can be stented endoscopically. Antimicrobial therapy is given to treat the infection but alone does not reduce the biliary tract damage or relieve symptoms.

Ursodeoxycholic acid may have a role in treating intrahepatic ductal sclerosis and cholestasis.

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