Diagnostic Value of Percutaneous Liver Biopsy for the Diagnosis of Fever of Unknown Origin in HIV-infected Patients

抄録

Fever of unknown origin (FUO) in HIV-infected patients remains a difficult problem. We sought to determine the clinical utility of percutaneous liver biopsy in diagnosing causes of FUO among HIV-infected patients, and define the factors associated with useful data attainment from this procedure. A retrospective study was conducted among HIV-infected patients with FUO who had undergone percutaneous liver biopsy in an HIV-care hospital. The results obtained from percutaneous liver biopsy were categorized into three groups: (1) diagnostic, (2) helpful and (3) not helpful. Diagnostic and helpful results were considered as useful data. There were 101 patients with a mean (SD) age of 37.6 (6.9) years. Median (IQR) CD4 was 18 (3-62) cells/mm³. Median (IQR) duration of fever was 20 (8-30) days. Percutaneous liver biopsy was diagnostic in 51 patients (50.5%), helpful in 12 (11.9%) and not helpful in 38 (37.6%). Multivariate analysis showed elevation of serum alkaline phosphatase level (OR 1.27 per one time elevation from upper normal range; 95% CI, 1.03-1.57; p=0.023) and fever of less than 3 weeks (OR 3.82; 95% CI, 1.03-14.18; p=0.046) were significantly associated with useful data attainment. This report suggests percutaneous liver biopsy is still a useful diagnostic tool for HIV-infected patients with FUO.