PMC5088554_01
Magnetic resonance imaging shows an intrahepatic bile duct stricture and pruned-tree appearance, mainly in the anterior segment of the right hepatic lobe (a, b). Magnetic resonance imaging at 15 months after the initiation of cART shows further focal dilatation in the intrahepatic bile duct (arrowhead) (c, d).
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Magnetic resonance cholangiopancreatography (MRCP) revealed an intrahepatic bile duct stricture and pruned-tree appearance, mainly in the anterior segment of the right hepatic lobe, indicating sclerosing cholangitis (Fig. 1a and b). Follow-up MRCP performed at 15 months after the initiation of cART showed further focal dilatation in an intrahepatic bile duct, with a persistent pruned-tree appearance, similar to findings in primary sclerosing cholangitis (Fig. 1c and d).
The clinical course of laboratory findings after the initiation of cART. The time-dependent levels of HIV-1 viral load and CD4 cell count (upper panel) and AST, ALT, ALP and LDH (lower panel) are shown. After the initiation of cART, the AST, ALT, ALP, and LDH levels returned to within the normal ranges.
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The HIV viral load became undetectable after 4 months of therapy, and the CD4 cell count increased to over 200 cells/muL within 2 months of cART initiation (Fig. 2). Following the increase in the CD4 cell count, the patient's hepatic and biliary enzyme levels normalized immediately (Fig. 2).