Aids cholangiopathy

[Greta]

AIDS cholangiopathy is biliary obstruction secondary to biliary tract strictures caused by various opportunistic infections.
(See also Overview of Biliary Function.)
Before the advent of antiretroviral therapy, cholangiopathy occurred in 25% of patients with AIDS, especially in those with a low CD4 count (lt; 100/mcL). The most common pathogen is Cryptosporidium parvum. Others include cytomegalovirus, microsporidia, and Cyclospora species. Papillary stenosis or intrahepatic or extrahepatic sclerosing cholangitis develops in most patients. Over half have both.
Common symptoms include right upper quadrant and epigastric pain and diarrhea. A few patients have fever and jaundice. Severe pain usually indicates papillary stenosis. Milder pain suggests sclerosing cholangitis. The diarrhea reflects small-bowel infection, often cryptosporidiosis.