Objective To summarize the clinical characteristics of patients with HIV/AIDS and liver injury. Methods A total of 53 HIV antibody-positive patients with liver injuries were enrolled as research subjects and were divided into the viral hepatitis group (n=27), hepatocellular carcinoma group (n=15), or hepatic diffuse large B-cell lymphoma group (n=11) according to their histopathological assessments results of livers. The clinical symptoms and abdominal CT imaging characteristics, as well as histopathological assessments results of livers and immunophenotypes, were compared between the three groups. Results There were statistically significant differences in weight loss, fever, epigastric pain, and superficial lymph node enlargement, as well as increased levels of alanine transaminase, alkaline phosphatase, and alpha-fetoprotein, between the three groups; there were statistically significant differences in multiple nodules, single nodule, heterogenous enhancement of lesions, mild enhancement of lesions, and severe enhancement of lesions between the three groups (all P<0.05). Under the microscope, destructed hepatic lobules could be observed in the viral hepatitis group, coagulative necrosis tissues could be observed in the hepatocellular carcinoma group, and extensively destructed hepatic lobules and starry sky patterns could be observed in the hepatic diffuse large B-cell lymphoma group. Conclusion The clinical symptoms, laboratory tests results, and abdominal CT imaging characteristics of different types of patients with HIV/AIDS and liver injury are different, but according to which it is difficult to distinguish between hepatocellular carcinoma and hepatic diffuse large B-cell lymphoma, and the differential diagnosis of the above two requires methods like liver histopathology and immunophenotyping.

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