A New Cause of Liver Disease in HIV

Although most chronic progressive liver disease in HIV-infected individuals is readily ascribed to viral coinfection, alcohol use, or drug toxicity, some cases remain mysterious. French researchers describe eight cases of portal hypertension associated with nodular regenerative hyperplasia (NRH), an uncommon condition in which small regenerative nodules without significant fibrosis cause portal hypertension without hepatocellular failure. The pathogenesis is not completely understood.

All eight patients were referred for liver biopsy because of evident liver dysfunction (cholestasis, pancytopenia, or clinical evidence of portal hypertension). Other causes of liver disease were excluded. All patients were taking potent combination antiretrovi…