AIDS cholangiopathy
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AIDS cholangiopathy refers to an acalculous, secondary opportunistic cholangitis that occurs in AIDS patients as a result of immunosuppression.
Pathology
Characterised by multiple irregular narrowingsstrictures essentially indistinguishable from primary sclerosing cholangitis (PSC). There are four pathological patterns:
- a 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 the 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
-<p><strong>AIDS cholangiopathy</strong> refers to an acalculous, secondary opportunistic <a href="/articles/cholangitis">cholangitis</a> that occurs in <a href="/articles/hivaids">AIDS</a> patients as result of immunosuppression. </p><h4>Pathology</h4><p>Characterised by multiple irregular narrowings essentially indistinguishable from <a href="/articles/primary-sclerosing-cholangitis-psc">primary sclerosing cholangitis (PSC)</a>. There are four pathological patterns </p><ul>-<li>combination of sclerosing cholangitis and papillary stenosis (50%)</li>- +<p><strong>AIDS cholangiopathy</strong> refers to an acalculous, secondary opportunistic <a href="/articles/cholangitis">cholangitis</a> that occurs in <a href="/articles/hivaids">AIDS</a> patients as a result of immunosuppression. </p><h4>Pathology</h4><p>Characterised by multiple irregular strictures essentially indistinguishable from <a href="/articles/primary-sclerosing-cholangitis-psc">primary sclerosing cholangitis (PSC)</a>. There are four pathological patterns: </p><ul>
- +<li>a combination of sclerosing cholangitis and papillary stenosis (50%)</li>
-</ul><h5>Aetiology</h5><p>No definite organism is identified in up to half of patients. It typically affects patients with low CD4 counts (<135/mm<sup>3</sup>). Postulated causative organisms include:</p><ul>- +</ul><h5>Aetiology</h5><p>No definite organism is identified in up to half of the patients. It typically affects patients with low CD4 counts (<135/mm<sup>3</sup>). Postulated causative organisms include:</p><ul>
-<li><a href="/articles/chemotherapy-induced-cholangitis">chemotherapy induced cholangitis</a></li>- +<li><a href="/articles/chemotherapy-induced-cholangitis">chemotherapy-induced cholangitis</a></li>
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