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Bone marrow findings in HIV infection: a pathological study
Progress in AIDS Pathology
|January 1, 1990
Summary
Human immunodeficiency virus type 1 (HIV-1) infection causes distinct bone marrow changes, including hypercellularity and myelodysplasia. These histopathologic findings aid in diagnosing HIV-1 infection and its complications.
Area of Science:
- Hematology
- Virology
- Pathology
Background:
- Bone marrow examination is crucial for assessing hematologic abnormalities in patients with Human Immunodeficiency Virus type 1 (HIV-1) infection.
- Understanding histopathologic changes in HIV-1 infection aids in diagnosis and management of associated complications.
Purpose of the Study:
- To describe the spectrum of bone marrow histopathologic changes in patients with HIV-1 infection.
- To correlate these changes with the stage of HIV-1 infection and identify opportunistic infections or neoplastic complications.
Main Methods:
- Histopathologic analysis of bone marrow biopsies from 73 patients at various stages of HIV-1 infection.
- Biopsies were performed due to peripheral blood abnormalities, suspected lymphoma, or to identify specific pathogens.
Main Results:
- Common findings included hypercellularity (67%), myelodysplasia (86.1%), plasmacytosis (98.6%), and lymphocytic infiltration (31.1%).
- Increased reticulin fibers (54.7%), iron deposits, vascular congestion, and serous atrophy of fat were also frequent.
- Opportunistic infections (Mycobacterium avium intracellulare, Cryptococcus neoformans, Toxoplasma gondii, Leishmania) and lymphomas (Burkitt, Hodgkin's disease) were identified in 7 patients.
Conclusions:
- Histopathologic changes in bone marrow are characteristic of HIV-1 infection, though non-pathognomonic.
- Bone marrow biopsy is valuable for diagnosing HIV-1 related complications, including opportunistic infections and malignancies.
- Bone marrow hypoplasia can be a terminal event in Acquired Immunodeficiency Syndrome (AIDS).