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Comprehensive & Cost Effective Laboratory Monitoring of HIV/AIDS: an African Role Model
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Comprehensive & Cost Effective Laboratory Monitoring of HIV/AIDS: an African Role Model

Published on: October 31, 2010

AIDS and the pancreas in the HAART era: a cross sectional study

Alexandre G Barbosa1, Ethel Z Chehter, Marcelo R Bacci

  • 1Department of General Practice, Faculdade de Medicina do ABC, Santo André, Brazil. mrbacci@yahoo.com.

International Archives of Medicine
|July 17, 2013
PubMed

Insights

Highly Active Antiretroviral Therapy (HAART) use in AIDS patients shows lighter pancreatic abnormalities. Autopsies revealed increased atrophy and apoptosis, but no direct lesions from HAART, suggesting therapy

Area of Science:

  • Pathology
  • Virology
  • Immunology

Background:

  • Acquired Immunodeficiency Syndrome (AIDS) patients on Highly Active Antiretroviral Therapy (HAART) exhibit distinct pancreatic morphological patterns.
  • Understanding these patterns is crucial for managing long-term complications in HIV-infected individuals.

Purpose of the Study:

  • To identify and characterize the main morphological patterns of the pancreas in AIDS patients receiving HAART.
  • To compare pancreatic morphology between HAART users and non-users.

Main Methods:

  • Cross-sectional study conducted in 2010, comparing 2010 autopsies of HAART users (2006-2009) with 109 AIDS patients from 1995 (pre-HAART).
  • Inclusion criteria: patients >18 years old, died of AIDS, and underwent autopsy.
  • Autopsies performed at the Death Verification Service of São Paulo.

Main Results:

  • HAART group showed milder pancreatic abnormalities compared to the non-HAART group.
  • Histology in the HAART group revealed a higher percentage of acinar cell atrophy and reduction of zymogen granules, with fewer 'dysplasia-like' features.
  • The exocrine pancreas in HAART patients was characterized by significant atrophy, reduced zymogen granules, and increased apoptosis, indicating degeneration and potentially lower malnutrition.

Conclusions:

  • Increased number and volume of islets of Langerhans with nuclear dysplasia were observed in the HAART group.
  • Antiviral therapy and longer survival led to increased pancreatic atrophy and enzyme reduction, raising apoptosis and altering pancreatic islets.
  • No direct histopathological pancreatic lesions secondary to antiretroviral therapy were identified.
Abstract

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