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Bone marrow findings in HIV infection: a pathological study

Progress in AIDS Pathology
|January 1, 1990
PubMed

Insights

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).

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