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Case Studies | Medical Science | India | Volume 13 Issue 4, April 2024

Severe Cholestatic Hepatitis in Retroviral Infection

Ravi Shankar Bagepally ^[5] | B Karthik Rao | Monalisa Sahu ^[4] | Milap Shah ^[4] | Vamsi Krishna Bodireddy ^[2] | Devasree C. Srinivasulu

Abstract: Cytomegalovirus (CMV) related hepatitis is usually characterized by cytopathic effects on hepatocytes, enlargement of infected cells with cytoplasmic and nuclear inclusions. Intranuclear inclusion have an owl eye morphology. Additional features include mild lobular hepatitis, portal infiltration and micro abscesses. Immunohistochemistry (DDG9 and CCH2 positivity) is used when CMV inclusion are not seen in H and E stain. We present the case of a HIV infected patient with severe cholestatic hepatitis and negative lab evaluation. Liver biopsy was not characteristic of CMV infection but viral load was elevated. Treatment with sequential course of ganciclovir - valganciclovir resulted in a successful outcome.

Keywords: Cholestatic Hepatitis, CMV infection, Ganciclovir, Plasmapheresis, ART

Edition: Volume 13 Issue 4, April 2024,

Pages: 1901 - 1904