Curbside Consultation of the Liver: 49 Clinical Questions

Mitchell L. Shiffman, MD

Question 17: What Things Could Cause My Patient With Hiv To Develop Jaundice? (continued)

Richard K. Sterling, MD, MSc, FACP, FACG

When evaluating the cause of jaundice in the human immunodeficiency virus (HIV)-positive patient, the first thing to determine is whether the patient is in acute liver failure (ALF) because this is a true emergency that requires hospitalization. If evidence of new-onset coagulopathy or encephalopathy is present, in the absence of preexisting liver disease, patients should be admitted and managed as ALF. Because those with HIV may be at increased risk for acute hepatitis A and B, or superinfection of hepatitis D in those with chronic B, these causes should be at the top of the list in any HIV…