Etiology of hepatobiliary disease by CD4 count

CD4 cell count (cells/microL)	Increased risk for^*:
<200	Cyclosporiasis
	Non-Hodgkin lymphoma
	Visceral leishmaniasis
<150	Disseminated histoplasmosis
<100	Bartonella henselae peliosis hepatitis
	AIDS cholangiopathy
	Talaromycosis
<50	Disseminated MAC infection
<50	Cystoisosporiasis

This list includes hepatobiliary disease etiologies commonly found in patients with HIV-associated immunosuppression. This list is not exhaustive and these individuals are also at risk for other causes of hepatobiliary disease. This table should be used in conjunction with the UpToDate topic on approach to the patient with HIV and hepatobiliary complaints. Patients virally suppressed on a stable ART regimen with CD4 counts that are persistently below 200 cells/microL are unlikely to present with the opportunistic infections/AIDS-associated malignancies listed above.

AIDS: acquired immunodeficiency syndrome; ART: antiretroviral therapy; HIV: human immunodeficiency virus; MAC: Mycobacterium avium complex.

* As the CD4 count decreases, the individual is at risk for more infections, including the ones listed for CD4 count thresholds higher than the individual's current CD4 count. For example, for an individual with a CD4 count of 130 cells/microL, that individual is at risk for disseminated histoplasmosis, as well as cyclosporiasis, visceral leishmaniasis, and non-Hodgkin lymphoma.

Graphic 147736 Version 2.0

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Etiology of hepatobiliary disease by CD4 count