Neuropathology of AIDS: An autopsy review of 284 cases from brazil comparing the findings pre- and post-HAART (highly active antiretroviral therapy) and pre- and postmortem correlation

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Abstract

A retrospective study of central nervous system (CNS) in 284 autopsy AIDS cases in Brazil (1989-2008) divided into 3 groups: A (without antiretroviral treatment: 163 cases); B (other antiretroviral therapies: 76 cases); C (HAART for 3 months or more: 45 cases). In 165 (58.1%) cases, relevant lesions were found, predominantly infections (54.2%); the most frequent was toxoplasmosis (29.9%) followed by cryptococcosis (15.8%), purulent bacterial infections (3.9%), and HIV encephalitis (2.8%); non-Hodgkin lymphomas occurred in 1.4% and vascular lesions in 1.1%. There was no difference when compared the frequency of lesion among the groups; however, toxoplasmosis was less common while HIV encephalitis was more frequent in group C related to A. CNS lesions remain a frequent cause of death in AIDS; however, the mean survival time was four times greater in group C than in A. In 91 (55.1%) of 165 cases with relevant brain lesions (or 32% of the total 284 cases), there was discordance between pre- and postmortem diagnosis; disagreement type 1 (important disease that if diagnosed in life could change the patient prognosis) occurred in 49 (53.8%) of 91 discordant cases (17.6% of the total 284) indicating the autopsy importance, even with HAART and advanced diagnostics technologies. © 2012 Ana Cristina Araújo Lemos Silva et al.

Figures

  • Table 1: Relevant morphological lesions in the central nervous system in 284 autopsies of patients with acquired immunodeficiency syndrome, according to the study groups.
  • Table 2: Average values of survival time (months) after diagnosis of HIV infection in 261 of 284 autopsies of acquired immunodeficiency syndrome, in which it was possible to obtain this information, according to the study groups.
  • Table 3: Comparison between different studies regarding lesions to the central nervous system, in a series of autopsies of patients with HIV infection.

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CITATION STYLE

APA

Silva, A. C. A. L., Rodrigues, B. S. C., Micheletti, A. M. R., Tostes, S., Meneses, A. C. O., Silva-Vergara, M. L., & Adad, S. J. (2012). Neuropathology of AIDS: An autopsy review of 284 cases from brazil comparing the findings pre- and post-HAART (highly active antiretroviral therapy) and pre- and postmortem correlation. AIDS Research and Treatment, 2012. https://doi.org/10.1155/2012/186850

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