Biliary Diseases in HIV

Manifestations of human immunodeficiency virus infection range from acute primary infections to life threatening symptomatic diseases that result from opportunistic infections. A Medline search was performed using the terms AIDS cholangiopathy, HIV hepatobiliary disease, HIV/AIDS acute acalculous cholecystitis, and AIDS sclerosing cholangitis to review the latest articles on biliary disease in HIV. These diseases fall into three categories: [1] AIDS cholangiopathy, [2] Acalculous cholecystitis, and [3] nonHIV related disease of the biliary system. This review paper will concentrate on the etiology, clinical presentations, diagnoses and treatment options of AIDS cholangiopathy and acalculous cholecystitis. Prior to the AIDS epidemic, diseases of the biliary tree with opportunistic organisms, such as Cryptosporidium and cytomegalovirus, were mostly unknown. While endoscopic retrograde cholangiopancreatography provides symptomatic relief in AIDS cholangiopathy, the availability of highly active antiretroviral therapy since 1996 is the main protective factor.