Changes in pathological findings at autopsy in AIDS cases for the last 15 years
Changes in pathological findings at autopsy in AIDS cases for the last 15 years
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DOI：
10.1097/00002030-200001070-00008
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发表时间：
2000-01-07
期刊：
影响因子：
3.8
通讯作者：
Hansen, LA
中科院分区：
文献类型：
--
作者：
Masliah, E;DeTeresa, RM;Hansen, LA
目的：分析艾滋病全身性病理随时间的变化及其与中枢神经系统病理的关系。设计与方法：对加州大学圣地亚哥分校医学中心1982~1998年收治的390例艾滋病尸检病例进行回顾性分析，用线性回归分析评价其随时间变化的意义。结果：总体上，巨细胞病毒、卡氏肺孢子虫肺炎和鸟型分枝杆菌感染的发生率随着时间的推移呈下降趋势，而细菌感染呈上升趋势，真菌感染的发生率保持不变。随着时间的推移，非霍格金氏淋巴瘤的发生率呈上升趋势，而卡波西肉瘤的发生率保持不变。在肺部受累之后(84%)，大脑仍然是第二大受累器官(63%)。虽然机会性感染或非霍格金氏淋巴瘤导致的脑部改变呈下降趋势，但至少有25%的病例继续检测到艾滋病毒脑炎。晚期HIV相关神经病理学病例和未累及脑部HIV的病例显示：伴随机会性感染和肿瘤的显著全身病理改变。相比之下，早期脑部病理(例如淋巴细胞性脑膜炎)的病例表现出最轻微的全身病理。总体而言，这些趋势在整个研究期间保持不变。结论：这项研究表明，尽管抗逆转录病毒和反机会性感染治疗有好处，但艾滋病毒累及大脑仍然是常见的尸检发现。(C)2000年Lippincott Williams&Wilkins。
Objective: To analyze changes in frequency of systemic AIDS pathology over time and its relationship to central nervous system pathology.Design and methods: A total of 390 AIDS:autopsy cases obtained at University of California at San Diego Medical Center from 1982 to 1998 were reviewed retrospectively and linear regression analysis was used to evaluate significance of changes over time.Results: Overall, the frequency of cytomegalovirus, Pneumocystis carinii pneumonia and Mycobacterium avium complex decreased, whereas bacterial infections increased and the frequency of fungal infection remained unchanged over time. The frequency of non-Hogdkin's lymphoma showed an upward trend over time, while the frequency of Kaposi's sarcoma remained unchanged. Following involvement of the lung (84%), the brain continued to be the second most frequently affected organ (63%). Whereas alterations of the brain by opportunistic infections or non-Hogdkin's lymphoma showed a downward trend, HIV encephalitis continued to be detected in at least 25% of the cases. Cases with advanced HIV-relaled neuropathology and cases with no HIV involvement of the brain showed:significant systemic pathology with opportunistic infections and neoplasms. In contrast, cases with early brain pathology (e.g., lymphocytic meningitis) showed minimal systemic pathology. Overall these trends remained unchanged throughout the total period covered by this study.Conclusions: This study suggests that despite the beneficial effects of antiretroviral and anti-opportunistic infection therapy, involvement of the brain by HIV continues to be a frequent autopsy finding. (C) 2000 Lippincott Williams & Wilkins.