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Pathological lesions in HIV positive patients
V Santosh1, S K Shankar, S Das
1Department of Neuropathology, National Institute of Mental Health & Neuro Sciences, Bangalore.
The Indian Journal of Medical Research
|April 1, 1995
Summary
This study details the pathomorphological findings in 10 individuals with human immunodeficiency virus (HIV). Opportunistic infections, particularly cryptococcal meningitis and tuberculosis, were prevalent, highlighting the need for HIV screening in such cases.
Area of Science:
- Pathology
- Infectious Diseases
- Neurology
Background:
- Human immunodeficiency virus (HIV) infection significantly impacts the immune system, leading to acquired immunodeficiency syndrome (AIDS).
- Opportunistic infections (OIs) are a major cause of morbidity and mortality in individuals with advanced HIV/AIDS.
- Understanding the spectrum of OIs and their pathological manifestations is crucial for diagnosis and management.
Purpose of the Study:
- To describe the pathomorphological features of various opportunistic infections in HIV-positive individuals.
- To identify common and uncommon OIs affecting the central nervous system (CNS) and other organs.
- To emphasize the importance of considering HIV in patients with specific OIs and vice versa.
Main Methods:
- Autopsy and biopsy samples from 10 HIV-positive individuals were analyzed.
- Pathological examination focused on identifying infectious agents and tissue damage.
- Clinical data and autopsy findings were correlated.
Main Results:
- Nine out of ten patients exhibited neuro-AIDS, with eight succumbing to OIs.
- Cryptococcal meningitis was the most frequent CNS OI (5 cases), with disseminated cryptococcosis in 2.
- Other OIs included toxoplasma encephalitis (2), acanthamoeba infection (1), pulmonary tuberculosis (3), and various bacterial infections (3).
- One asymptomatic HIV individual had early HIV-associated leukoencephalopathy.
Conclusions:
- Opportunistic infections are a primary cause of death in HIV-positive individuals, particularly affecting the CNS.
- Bacterial infections, beyond Mycobacterium tuberculosis, are often underdiagnosed in AIDS patients, especially in developing nations.
- Screening for HIV is recommended in patients presenting with cryptococcal or tuberculous meningitis, or multiple parasitic infections.