       Document 1069
 DOCN  M9621069
 TI    Diagnosis and prognosis of AIDS-related cholangitis.
 DT    9602
 AU    Ducreux M; Buffet C; Lamy P; Beaugerie L; Fritsch J; Choury A; Liguory
       C; Longuet P; Gendre JP; Vachon F; et al; Department of
       Hepato-Gastroenterology, Bicetre Hospital, Le; Kremlin Bicetre, France.
 SO    AIDS. 1995 Aug;9(8):875-80. Unique Identifier : AIDSLINE MED/96014960
 AB    OBJECTIVE: To determine more precisely the clinical and biological
       characteristics of AIDS-related cholangitis, and to investigate
       prognostic variables of this disease. DESIGN: Retrospective clinical and
       prognostic study. SETTING: Biliary unit, Bicetre Hospital, France.
       PATIENTS: HIV-positive patients (n = 52) referred to the unit between
       December 1986 and June 1993 for biliary symptoms leading to the
       suspicion of AIDS-related cholangitis, (42 men; 10 women; mean age, 37
       +/- 8 years). INTERVENTION: Endoscopic retrograde
       cholangiopancreatography (ERCP) was performed in order to determine the
       cause of the biliary symptoms. MAIN OUTCOME MEASURE: Clinical features
       and evolution of the cholangitis. RESULTS: Among the 52 patients, 45 met
       the ERCP criteria of AIDS-related cholangitis (36 men; nine women). The
       diagnosis of cholangitis was strongly suggested by abdominal
       ultrasonography in 47% of the cases. ERCP showed papillary stenosis,
       diffuse cholangitis, extrahepatic cholangitis alone, and intrahepatic
       cholangitis alone in 60, 67, 7 and 27%, respectively. Endoscopic
       sphincterotomy was performed in 28 patients. Pain was relieved by
       sphincterotomy in nine patients, but the other clinical or biological
       features were not influenced. One-year and 2-year survival rates were 41
       +/- 7% and 8 +/- 4%, respectively. Multidimensional analysis using a Cox
       model showed that a lymphocyte count > 500 x 10(6)/l was the only
       independent predictive factor of better survival. CONCLUSION:
       AIDS-related cholangitis is a disease which leads preferentially to
       papillary stenosis or diffuse abnormalities of the biliary tract.
       Prognostic factors depend on the stage of the HIV infection. Another
       diagnosis of cholestasis was found in approximately 15% of the patients
       who showed biliary symptoms.
 DE    Acquired Immunodeficiency Syndrome/*COMPLICATIONS  Adult  Alanine
       Aminotransferase/BLOOD  Alkaline Phosphatase/BLOOD  Bilirubin/BLOOD
       Cholangiopancreatography, Endoscopic Retrograde
       Cholangitis/*COMPLICATIONS/*DIAGNOSIS/SURGERY  Female  Human  Lymphocyte
       Count  Male  Middle Age  Prognosis  Retrospective Studies
       Sphincterotomy, Endoscopic  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

