Etiology, evaluation, and outcome of jaundice in patients with acquired immunodeficiency syndrome

Naga Chalasani, C. Mel Wilcox

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Although liver test abnormalities are frequently identified in patients with acquired immunodeficiency syndrome (AIDS), the causes, evaluation, and outcome of jaundice in these patients have not been systematically evaluated. From August 1, 1990 through September 1, 1994, all human immunodeficiency virus (HIV)-infected patients with liver test abnormalities seen by the gastroenterology service at a large, inner-city hospital were prospectively identified. Jaundice was defined as a serum bilirubin concentration ≥3 mg/dL. The etiology of jaundice was determined by the pattern of liver biochemistry test abnormalities, radiographic studies, liver biopsy, clinical follow-up, and autopsy. During the study period, 541 HIV-infected patients (511 with AIDS) were evaluated for liver disease by our service; 36 of these patients had jaundice (7%). The most common causes of jaundice were drug- induced hepatitis, occurring in 11 patients (31%), and alcoholic liver disease, occurring in 5 (13%). Opportunistic infections or neoplasms were identified as the cause of jaundice in 11 patients (30%), with 4 having intrahepatic disease and 7 having extrahepatic disease. Multiple potential causes were seen in 3 patients. Abdominal ultrasonography (US) and computed tomography (CT) were helpful in suggesting the underlying cause of disease. The short-term mortality was high, with 9 patients dying during the hospitalization (25%) and 7 patients dying within 6 months of evaluation. Liver disease was the cause of death in 7 of these patients. In conclusion, jaundice is uncommon in AIDS and may result from a variety of both opportunistic and non-opportunistic etiologies. Drug-induced hepatitis is the most common cause and may be fatal. Long-term survival was poor.

Original languageEnglish (US)
Pages (from-to)728-733
Number of pages6
JournalHepatology
Volume23
Issue number4
DOIs
StatePublished - 1996
Externally publishedYes

Fingerprint

Jaundice
Acquired Immunodeficiency Syndrome
Chemical and Drug Induced Liver Injury
Liver
Liver Diseases
HIV
Alcoholic Liver Diseases
Urban Hospitals
Opportunistic Infections
Gastroenterology
Bilirubin
Biochemistry
Cause of Death
Autopsy
Ultrasonography
Hospitalization
Tomography
Biopsy
Survival
Mortality

ASJC Scopus subject areas

  • Hepatology

Cite this

Etiology, evaluation, and outcome of jaundice in patients with acquired immunodeficiency syndrome. / Chalasani, Naga; Wilcox, C. Mel.

In: Hepatology, Vol. 23, No. 4, 1996, p. 728-733.

Research output: Contribution to journalArticle

@article{315fd28fe09447f08c2ea003ec4da5eb,
title = "Etiology, evaluation, and outcome of jaundice in patients with acquired immunodeficiency syndrome",
abstract = "Although liver test abnormalities are frequently identified in patients with acquired immunodeficiency syndrome (AIDS), the causes, evaluation, and outcome of jaundice in these patients have not been systematically evaluated. From August 1, 1990 through September 1, 1994, all human immunodeficiency virus (HIV)-infected patients with liver test abnormalities seen by the gastroenterology service at a large, inner-city hospital were prospectively identified. Jaundice was defined as a serum bilirubin concentration ≥3 mg/dL. The etiology of jaundice was determined by the pattern of liver biochemistry test abnormalities, radiographic studies, liver biopsy, clinical follow-up, and autopsy. During the study period, 541 HIV-infected patients (511 with AIDS) were evaluated for liver disease by our service; 36 of these patients had jaundice (7{\%}). The most common causes of jaundice were drug- induced hepatitis, occurring in 11 patients (31{\%}), and alcoholic liver disease, occurring in 5 (13{\%}). Opportunistic infections or neoplasms were identified as the cause of jaundice in 11 patients (30{\%}), with 4 having intrahepatic disease and 7 having extrahepatic disease. Multiple potential causes were seen in 3 patients. Abdominal ultrasonography (US) and computed tomography (CT) were helpful in suggesting the underlying cause of disease. The short-term mortality was high, with 9 patients dying during the hospitalization (25{\%}) and 7 patients dying within 6 months of evaluation. Liver disease was the cause of death in 7 of these patients. In conclusion, jaundice is uncommon in AIDS and may result from a variety of both opportunistic and non-opportunistic etiologies. Drug-induced hepatitis is the most common cause and may be fatal. Long-term survival was poor.",
author = "Naga Chalasani and Wilcox, {C. Mel}",
year = "1996",
doi = "10.1053/jhep.1996.v23.pm0008666325",
language = "English (US)",
volume = "23",
pages = "728--733",
journal = "Hepatology",
issn = "0270-9139",
publisher = "John Wiley and Sons Ltd",
number = "4",

}

TY - JOUR

T1 - Etiology, evaluation, and outcome of jaundice in patients with acquired immunodeficiency syndrome

AU - Chalasani, Naga

AU - Wilcox, C. Mel

PY - 1996

Y1 - 1996

N2 - Although liver test abnormalities are frequently identified in patients with acquired immunodeficiency syndrome (AIDS), the causes, evaluation, and outcome of jaundice in these patients have not been systematically evaluated. From August 1, 1990 through September 1, 1994, all human immunodeficiency virus (HIV)-infected patients with liver test abnormalities seen by the gastroenterology service at a large, inner-city hospital were prospectively identified. Jaundice was defined as a serum bilirubin concentration ≥3 mg/dL. The etiology of jaundice was determined by the pattern of liver biochemistry test abnormalities, radiographic studies, liver biopsy, clinical follow-up, and autopsy. During the study period, 541 HIV-infected patients (511 with AIDS) were evaluated for liver disease by our service; 36 of these patients had jaundice (7%). The most common causes of jaundice were drug- induced hepatitis, occurring in 11 patients (31%), and alcoholic liver disease, occurring in 5 (13%). Opportunistic infections or neoplasms were identified as the cause of jaundice in 11 patients (30%), with 4 having intrahepatic disease and 7 having extrahepatic disease. Multiple potential causes were seen in 3 patients. Abdominal ultrasonography (US) and computed tomography (CT) were helpful in suggesting the underlying cause of disease. The short-term mortality was high, with 9 patients dying during the hospitalization (25%) and 7 patients dying within 6 months of evaluation. Liver disease was the cause of death in 7 of these patients. In conclusion, jaundice is uncommon in AIDS and may result from a variety of both opportunistic and non-opportunistic etiologies. Drug-induced hepatitis is the most common cause and may be fatal. Long-term survival was poor.

AB - Although liver test abnormalities are frequently identified in patients with acquired immunodeficiency syndrome (AIDS), the causes, evaluation, and outcome of jaundice in these patients have not been systematically evaluated. From August 1, 1990 through September 1, 1994, all human immunodeficiency virus (HIV)-infected patients with liver test abnormalities seen by the gastroenterology service at a large, inner-city hospital were prospectively identified. Jaundice was defined as a serum bilirubin concentration ≥3 mg/dL. The etiology of jaundice was determined by the pattern of liver biochemistry test abnormalities, radiographic studies, liver biopsy, clinical follow-up, and autopsy. During the study period, 541 HIV-infected patients (511 with AIDS) were evaluated for liver disease by our service; 36 of these patients had jaundice (7%). The most common causes of jaundice were drug- induced hepatitis, occurring in 11 patients (31%), and alcoholic liver disease, occurring in 5 (13%). Opportunistic infections or neoplasms were identified as the cause of jaundice in 11 patients (30%), with 4 having intrahepatic disease and 7 having extrahepatic disease. Multiple potential causes were seen in 3 patients. Abdominal ultrasonography (US) and computed tomography (CT) were helpful in suggesting the underlying cause of disease. The short-term mortality was high, with 9 patients dying during the hospitalization (25%) and 7 patients dying within 6 months of evaluation. Liver disease was the cause of death in 7 of these patients. In conclusion, jaundice is uncommon in AIDS and may result from a variety of both opportunistic and non-opportunistic etiologies. Drug-induced hepatitis is the most common cause and may be fatal. Long-term survival was poor.

UR - http://www.scopus.com/inward/record.url?scp=0029968667&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0029968667&partnerID=8YFLogxK

U2 - 10.1053/jhep.1996.v23.pm0008666325

DO - 10.1053/jhep.1996.v23.pm0008666325

M3 - Article

C2 - 8666325

AN - SCOPUS:0029968667

VL - 23

SP - 728

EP - 733

JO - Hepatology

JF - Hepatology

SN - 0270-9139

IS - 4

ER -