Post-mortem histological pulmonary analysis in patients with HIV/AIDS
Clinics
;
63(4): 497-502, 2008. tab
Artículo
en Inglés
| LILACS
| ID: lil-489659
ABSTRACT
OBJECTIVES:
Certain aspects of pulmonary pathology observed in autopsies of HIV/AIDS patients are still unknown. This study considers 250 autopsies of HIV/AIDS patients who died of acute respiratory failure and describes the demographic data, etiology, and histological pulmonary findings of the various pathologies.METHODS:
The following data were obtained age, sex, and major associated diseases (found at the autopsy). Pulmonary histopathology was categorized as diffuse alveolar damage; pulmonary edema; alveolar hemorrhage; and acute interstitial pneumonia. Odds ratio of the HIV/AIDS-associated diseases developing a specific histopathological pattern was determined by logistic regression.RESULTS:
A total of 197 men and 53 women were studied. The mean age was 36 years. Bacterial bronchopneumonia was present in 36 percent (91 cases) and Pneumocystis jiroveci pneumonia in 27 percent (68) of patients. Pulmonary histopathology showed acute interstitial pneumonia in 40 percent (99), diffuse alveolar damage in 36 percent (89), pulmonary edema in 13 percent (33), and alveolar hemorrhage in 12 percent (29) of patients. Multivariate analysis showed a significant and positive association between Pneumocystis jiroveci pneumonia and acute interstitial pneumonia (Odds ratio, 4.51; 95 percent CI, 2.46 - 8.24; p < 0.001), severe sepsis and/or septic shock and diffuse alveolar damage (Odds ratio, 3.60; 95 percent CI, 1.78 -7.27; p < 0.001), and cytomegalovirus and acute interstitial pneumonia (Odds ratio, 2.22; 95 percent CI, 1.01 - 4.93; p = 0.05).CONCLUSIONS:
This report is the first autopsy study to include demographic data, etiologic diagnosis, and respective histopathological findings in patients with HIV/AIDS and acute respiratory failure. Further studies are necessary to elucidate the complete pulmonary physiopathological mechanism involved with each HIV/AIDS-associated disease.
Texto completo:
Disponible
Índice:
LILACS (Américas)
Asunto principal:
Insuficiencia Respiratoria
/
Infecciones por VIH
/
Pulmón
Tipo de estudio:
Estudio observacional
/
Factores de riesgo
Límite:
Adolescente
/
Adulto
/
Niño
/
Child, preschool
/
Femenino
/
Humanos
/
Lactante
/
Masculino
Idioma:
Inglés
Revista:
Clinics
Asunto de la revista:
Medicina
Año:
2008
Tipo del documento:
Artículo
País de afiliación:
Brasil
Institución/País de afiliación:
Universidade de São Paulo/BR
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