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.

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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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