Abstract

Hepatobiliary diseases occur commonly in patients with Human immunodeficiency virus (HIV) infection and are now the commonest cause of death in HIV positive patients on antiretroviral therapy (ART) in western countries. The hepatobiliary manifestations of AIDS are related to the levels of CD4+ count as well as liver enzymes. Abdominal ultrasound examination is easy to perform, non-invasive, inexpensive, readily available and provides valuable information about hepatobiliary findings in AIDS. The study was to evaluate hepatobiliary sonographic findings in HIV/AIDS adult patients and correlate with their CD4+ count and abnormal liver enzymes (ALP, ALT and AST) in Jos, Plateau State, Nigeria. A cross-sectional study of hepatobiliary ultrasound findings of 410 adult patients with HIV/AIDS was carried out over a period of six months. Two hundred and sixteen (52.7%) of the patients had normal hepatobiliary ultrasound findings while 194 (47.3%) patients had various abnormalities. The common abnormalities seen include enlarged gallbladder in 33.5%, increased liver parenchymal echogenicity in 26.3%, hepatomegaly in 23.7%, and thickened gallbladder wall in 7.8% patients. Other findings included gallbladder sludge and gall stone in 6.6 and 2.1% respectively. These findings correlated significantly with the patients’ CD4+ count and liver enzymes (ALT, AST and ALP) with p value < 0.05 in both. Ultrasonography as a baseline imaging modality in HIV/AIDS patients, together with CD4+ count and liver enzymes are useful in the assessment of the disease state, monitoring of therapy and management of these patients.

Key words: Hepatobiliary ultrasonography, adult patients, CD4 cell count, HIV/AIDS, liver enzymes.