Estudo ultrassonográfico das alterações hepato-biliares e esplênicas em pacientes portadores do HIV tratados com Retrovir-AZT (Zidovudina)

Abstract

This study evaluated, through ultrasound, the hepatobiliary and splenic alterations of adult patients with a confirmed diagnosis of AIDS, comparing a group of 51 individuals treated with Retrovir®-AZT (Zidovudine) at a dose of 500 mg/day for 6 to 24 months with another group of 26 not yet undergoing any type of antiviral therapy. Liver function was also evaluated through laboratory tests of AST, PT, PT, and bilirubin. A simple linear regression analysis, performed previously, did not find any influence of treatment time, sex, or age on the results obtained. The treated group presented a liver (right lobe) with an average size of 15.43 ± 2.3 mm, which, when compared to normal standards and the control group (11.04 ± 1.2 mm), showed a significantly increased size (p<0.05). In the first group, 88.24% of patients had hepatomegaly, and on ultrasound, almost all of its components (90.24%) presented steatotic echotexture. Ultrasonographic study of the gallbladder and biliary tract in this same group showed vesicular parietal thickening with echogenic content inside, suggesting acalculous cholecystitis, in 16 patients of the treated group (31.37%). Of these, 13 (81.25%) also presented alterations in bilirubin levels. Although the biliary tract alterations were not significant, all these patients presented associated hepatomegaly. On the other hand, contrary to other data in the literature that show splenomegaly as the main alteration evidenced by ultrasound in AIDS patients, only 11 patients (21.56%) of the treated group and 2 of the control group (8%) presented significant alterations in spleen size. Other liver function tests showed that, of 45 patients in the treated group who developed hepatomegaly, 38 had AST and/or CPT values ​​above normal, representing 84.44%. Regarding the evaluation of PT values, it was found that 22 (48.8%) of the patients with hepatomegaly in the treated group had values ​​equal to or less than 80%. These results suggest that ultrasound may be an excellent diagnostic tool for evaluating the main organs affected by AIDS and the simultaneous toxicity of antiviral drugs.