Case Report
Copyright ©2010 Baishideng. All rights reserved.
World J Gastroenterol. Jul 14, 2010; 16(26): 3335-3338
Published online Jul 14, 2010. doi: 10.3748/wjg.v16.i26.3335
Vanishing bile duct syndrome in human immunodeficiency virus: Nevirapine hepatotoxicity revisited
Rajan Kochar, Moises I Nevah, Frank J Lukens, Michael B Fallon, Victor I Machicao
Rajan Kochar, Moises I Nevah, Frank J Lukens, Michael B Fallon, Victor I Machicao, Division of Gastroenterology, Hepatology and Nutrition, The University of Texas Health Science Center at Houston, Houston, TX 77030, United States
Author contributions: Kochar R, Nevah MI, Lukens FJ, Fallon MB and Machicao VI contributed equally to the literature review and writing the paper.
Correspondence to: Rajan Kochar, MD, MPH, Professor, Division of Gastroenterology, Hepatology and Nutrition, The University of Texas Health Science Center at Houston, 7500 Kirby Drive, Apt 510, Houston, TX 77030, United States. rajankochar@gmail.com
Telephone: +1-713-5006677 Fax: +1-713-5006699
Received: January 30, 2010
Revised: April 27, 2010
Accepted: May 4, 2010
Published online: July 14, 2010
Abstract

Vanishing bile duct syndrome (VBDS) refers to a group of disorders characterized by prolonged cholestasis as a result of destruction and disappearance of intrahepatic bile ducts. Multiple etiologies have been indentified including infections, neoplastic disorders, autoimmune conditions and drugs. The natural history of this condition is variable and may involve resolution of cholestasis or progression with irreversible damage. VBDS is extremely rare in human immunodeficiency virus (HIV)-infected patients and anti-retroviral therapy has never been implicated as a cause. We encountered a young pregnant female with HIV and VBDS secondary to anti-retroviral therapy. Here, we report her clinical course and outcome.

Keywords: Vanishing bile duct syndrome; Ductopenia; Acquired immune deficiency syndrome; Cholangiopathy; Cholestasis; Drug-induced liver injury