Liver sonography and histopathology: Correlations in AIDS patients

Background: The liver is commonly affected in patients with acquired immune deficiency syndrome (AIDS), and ultrasonography of the liver often shows abnormalities. The purpose of this study was to correlate liver ultrasonography patterns with the underlying histopathologic processes in AIDS patients. Materials and Methods: Eighteen AIDS patients who had had both liver ultrasound (US) and biopsy were enrolled in this study. Results: Only one case showed negative results. The most common abnormality on ultrasonography was heterogenous hyperechoic liver seen in 61% of the patients. In this group, a specific diagnosis could be made in 58% of patients. In four cases of heterogenous hyperechoic liver with hepatosplenomegaly, three (75%) showed mycobacterium infection. In comparison, in eight cases of heterogenous hyperechoic liver without hepatosplenomegaly, only two (25%) had mycobacterium infection. One case of acalculous common bile duct dilatation showed cytomegalovirus infection of the biliary tract. Conclusion: In AIDS patients, abnormality of the liver on ultrasonography is frequently observed and the imaging technique is very useful in specific groups of patients. In those patients with a heterogenous hyperechoic liver, a biopsy should be performed to obtain a specific diagnosis.