Morphological changes in the digestive system of 322 necropsies of patients with acquired immune deficiency syndrome: comparison of findings pre- and post-HAART (Highly Active Antiretroviral Therapy)

Authors

  • Lucinda Calheiros Guimarães Universidade Federal do Triângulo Mineiro; Departamento de Patologia Especial
  • Ana Cristina Araújo Lemos da Silva Universidade Federal do Triângulo Mineiro; Departamento de Patologia Especial
  • Adilha Misson Rua Micheletti Universidade Federal do Triângulo Mineiro; Departamento de Patologia Especial
  • Everton Nunes Melo Moura Universidade Federal do Triângulo Mineiro; Departamento de Patologia Especial
  • Mario Léon Silva-Vergara Universidade Federal do Triângulo Mineiro; Departamento de Patologia Especial
  • Sebastião Tostes Júnior Universidade Federal do Triângulo Mineiro; Departamento de Patologia Especial
  • Sheila Jorge Adad Universidade Federal do Triângulo Mineiro; Departamento de Patologia Especial

Keywords:

Autopsy, Necropsy, AIDS, Digestive system, HAART

Abstract

Involvement of the digestive system in AIDS pathologies or injuries is frequent. Aiming at comparing the frequency, the importance that these lesions have for death and the survival time in patients using or not using HAART, we studied 322 necropsies classified as follows: Group A - without antiretroviral drugs (185 cases); B - one or two antiretroviral drugs or HAART for less than six months (83 cases); C - HAART for six months or longer (54 cases). In the overall analysis of the digestive system, changes were present in 73.6% of cases. The most frequent was Candida infection (22.7%), followed by cytomegalovirus (19.2%), Histoplasma capsulatum (6.5%), mycobacteria (5.6%), and Toxoplasma gondii (4.3%). T. gondii infection was more frequent in group A compared with group C, and cytomegalovirus (CMV) was more frequent in group A compared with groups B and C (p < 0.05); 2.2% of the deaths were due to gastrointestinal bleeding. Regarding the segments, only in the large intestine, and only cytomegalovirus, were more frequent in group A compared with group C. We conclude that digestive system infections are still frequent, even with the use of HAART. However, the average survival time in group C was more than three times greater than the one in group A and nearly double that of group B, demonstrating the clear benefit of this therapy.

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Published

2017-01-01

Issue

Section

Original Articles

How to Cite

Morphological changes in the digestive system of 322 necropsies of patients with acquired immune deficiency syndrome: comparison of findings pre- and post-HAART (Highly Active Antiretroviral Therapy). (2017). Revista Do Instituto De Medicina Tropical De São Paulo, 59, e3. https://revistas.usp.br/rimtsp/article/view/130558