Yavuz Arda, Girgin Rabia Burçin, Tuncer İlyas
Department of Gastroenterology, Istanbul Medeniyet University, School of Medicine, Istanbul, Turkey.
Department of Pathology, Istanbul Medeniyet University, School of Medicine, Istanbul, Turkey.
Eur J Case Rep Intern Med. 2020 Oct 13;7(12):001981. doi: 10.12890/2020_001981. eCollection 2020.
Human immunodeficiency virus (HIV) is a worldwide disease with an increasing number of cases globally. Initially, HIV cholangiopathy was often observed among such patients but has become rare after three decades because of the availability of new treatment options and potent antiretroviral drugs. Consequently, its occurrence now suggests drug resistance or disease progression. The relationship between cholangiocarcinoma and HIV remains unclear. We report the case of a patient with high-grade dysplasia of the ductus choledochus and uncontrolled disease which was treated with potent antiviral agents and bile duct dilatation.
HIV cholangiopathy should be kept in mind in an HIV-positive patient even if they are receiving combination antiretroviral therapy (cART); endoscopic retrograde cholangiopancreatography can provide symptomatic relief.Once HIV cholangiopathy is detected, close follow-up for cholangiocarcinoma is required.Opportunistic infections can cause cholangiocarcinoma in HIV-positive patients.
人类免疫缺陷病毒(HIV)是一种全球性疾病,全球病例数不断增加。最初,HIV胆管病常在这类患者中观察到,但由于新的治疗选择和强效抗逆转录病毒药物的出现,三十年后已变得罕见。因此,其现在的出现提示耐药或疾病进展。胆管癌与HIV之间的关系仍不清楚。我们报告了一例胆总管高级别发育异常且疾病未得到控制的患者,该患者接受了强效抗病毒药物和胆管扩张治疗。
即使HIV阳性患者正在接受联合抗逆转录病毒疗法(cART),也应考虑HIV胆管病;内镜逆行胰胆管造影可缓解症状。一旦检测到HIV胆管病,需要密切随访胆管癌。机会性感染可导致HIV阳性患者发生胆管癌。