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[Dissociated cholestasis in patients with HIV-1 infection, Prevalence and diagnostic value of liver biopsy].

HIV-1 infected patients frequently develop opportunistic diseases involving the liver, particularly individuals with AIDS. Nevertheless, the role of liver biopsy (LB) in these patients is controversial. The prevalence of AC in seropositive subjects and the value of LB in patients with AC was investigated. The prevalence of AC in all outpatients attended at our Unit for a three month period was 2/119 (1.6%), whereas it was 20/66 (30.3%) for inpatients for a nine month period. LB was proposed to all patients with AC but not to those with a Karnofski index < 50 and those with an ethanol intake > 80 g per day. LB was performed in 16 patients, four were excluded, and 2 refused the procedure. Among symptomatic patients, LB: a) confirmed a previous diagnosis in six patients (40%); b) showed findings of nonspecific cholangitis in four cases (27%), and c) disclosed a previously unsuspected or unconfirmed disease in five patients (33%). LB is an useful diagnostic tool for the diagnosis of seropositive patients with AC, although a previous opportunistic event may account for symptoms and the corresponding enzymatic patterns.