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Opportunistic Infections in Patients with HIV/AIDS at the Hospital Universitario de Santander: An Anatomopathological Study in the Period 2004–2016

BACKGROUND: HIV/AIDS-related infections are commonly presented in a disseminated form, compromising a high variety of organs and systems, mainly the Respiratory and Central Nervous System (CNS). In developing countries, the opportunistic agent spectrum varies from what is reported in the rest of the...

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Detalles Bibliográficos
Autores principales: Hernández, Julio César Mantilla, Ojeda, Olga Mercedes Alvarez, Torra, Kihara Alejandra Jerez
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5631592/
http://dx.doi.org/10.1093/ofid/ofx163.438
Descripción
Sumario:BACKGROUND: HIV/AIDS-related infections are commonly presented in a disseminated form, compromising a high variety of organs and systems, mainly the Respiratory and Central Nervous System (CNS). In developing countries, the opportunistic agent spectrum varies from what is reported in the rest of the world, being the anatomical compromise also different from developed countries reports. In Colombia there has not been published any study that characterizes the anatomopathological findings of opportunistic infections in a sample of HIV/AIDS patients this size. METHODS: Descriptive retrospective study, adjusted to the current regulations on human research. A review of the autopsy protocols performed at the Department of Pathology of the Universidad Industrial de Santander (UIS) between 2004 and 2016 was executed, selecting those with HIV/AIDS and at least one opportunistic infection as the final diagnosis, of these there were evaluated the pathological findings and demographic variables. RESULTS: Among 3497 autopsy protocols reviewed, there were found 249 cases of HIV/AIDS associated to opportunistic infections, 183 men (73,5%) and 66 women (26,5%), with an average age of 37.94 ± 12.56 years. The main compromised systems were the Lower Respiratory Tract (LRT) with 184 cases (73,8%), mainly by M. tuberculosis (76 cases; 41,3%), followed by the Central Nervous System (CNS) with 95 cases (38,1%), mainly by Toxoplasma gondii (38 cases; 20,6%), and in third place the Lymphoreticular System (LRS) with 92 cases (50%), mainly by Histoplasma capsulatum (39 cases; 21,1%). Less prevalent agents like Trypanosoma cruzi were found compromising multiple systems, with 6 infecting the CNS and 7 causing Chagasic myocarditis. CONCLUSION: Disseminated forms and simultaneous multiple agent compromise of one system are common features in HIV/AIDS patients, because of this the clinician must have a high level of suspicion for diagnosing coinfection when approaching a determinated organ or system compromised by an infectious agent. DISCLOSURES: All authors: No reported disclosures.