Abdominal AIDS Imaging: Hepatic, Splenic, Biliary, and Pancreatic Manifestations

The liver, spleen, pancreas, and biliary tract are commonly affected by opportunistic infections, malignancy, and inflammatory disorders during the course of human immune deficiency virus (HIV) infection (Table 9.1). Clinical manifestations of involvement of these organs are protean and usually nonspecific, but it is important to establish a specific diagnosis promptly in these often critically ill patients (Tshibwabwa et al. 2000). Because of the limitations of physical and laboratory examinations, cross-sectional imaging studies are often obtained to clarify the clinical situation (DeToma et al. 1999; Wu et al. 1998). This chapter reviews the imaging spectrum of HIV-associated hepatosplenic and pancreaticobiliary disease. Table 9.1 Hepatic splenic, biliary, and pancreatic disease associated with HIV infection Infection Bacterial Salmonella Rochalimaea Mycobacterial M. tuberculosis M. avium intracellulan complex M. xenopi Viral Cytomegalovirus Hepatitis B, C, and D Herpesvirus Adenovirus HIV Fungal Candida Cryptococcus Histoplasma Aspergillus Coccidia Sporothrix Protozoal Pneumocystis Cryptosporidia Microsporidia Leishmania Toxoplasma Neoplasms Non-Hodgkin’s lymphoma Kaposi’s sarcoma Metastatic cancer of anal canal Drug-related Trimethoprim-sulfamethoxazole Ketoconazole Isoniazid Rifampin Zidovudine Pentamidine Diphenylhydantoin Prochlorperazine Didanosine Fluconazole Oxacillin Dideoxyinosine