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
Table 1
Relevant morphological lesions in the central nervous system in 284 autopsies of patients with acquired immunodeficiency syndrome, according to the study groups.
Type of lesion
Group A
Group B
Group C
Total
%
%
%
%
Infections
97
59.5%
35
46%
22
48.9%
154
54.2%
Protozoa
59
36.2%
19
25.0%
8
17.8%
86
30.3%
Toxoplamosis
*59
36.2%
18
23.7%
*8
17.8%
85
29.9%
Amebiasis
0
0
1
1.3%
0
0
1
0.3%
Fungal
30
18.4%
12
15.8%
7
15.6%
49
17.2%
Cryptococosis
27
16.6%
11
14.5%
7
15.6%
45
15.8%
Histoplasmosis
2
1.2%
0
0
0
0
2
0.7%
Paracoccidioidomycosis
1
0.6%
0
0
0
0
1
0.3%
Sporotrichosis
0
0
1
1.3%
0
0
1
0.3%
Bacterial
†8
4.9%
3
3.9%
3
6.7%
†14
4.9%
Meningitis/encephalitis/abscess
5
3.1%
3
3.9%
3
6.7%
11
3.9%
Tuberculosis/mycobacteriosis
4
2.4%
0
0
0
0
4
1.4%
Virus
11
6.7%
2
2.6%
6
13.3%
19
6.7%
Cytomegalovirus
5
3.1%
1
1.3%
1
2.2%
7
2.5%
Nodular encephalitis
2
1.2%
1
1.3%
0
0
3
1.2%
HIV
*3
1.8%
0
0
*5
11.1%
8
2.8%
JC
1
0.6%
0
0
0
0
1
0.3%
Neoplasms
6
3.7%
1
1.3%
0
0
7
2.5%
Lymphoid Neoplasms
4
2.4%
1
1.3%
0
0
5
1.8%
Meningiomas
2
1.2%
0
0
0
0
2
0.7%
Vascular lesions
0
0
1
1.3%
2
4.4%
3
1.1%
Concomitant Lesions
11
3.9%
1
0.4%
2
0.7%
14
4.9%
Subtotal with relevant lesions
104
63.8%
37
48.7%
24
53.3%
165
58.1%
Subtotal normal or without relevants lesions
59
36.2%
39
51.3%
21
46.7%
119
41.9%
Total
163
100%
76
100%
45
100%
284
100%
Group A: without use of any antiretroviral medication; B: 1 or 2 antiretroviral therapy or HAART for any time less than 3 months; C: HAART for 3 months or more; ; test. Nonrelevant lesions occurred in 103 (36.3%) of 284 cases, represented by focal alterations, scarring or just edema related to the final events; in only 16 (5.6%) cases the brain was completely normal. †Among the cases with bacterial infection in group A, one patient showed concomitant infection by coccus and mycobacteria in different regions of the CNS (9 bacterial infections/8 patients).
