Morphological changes in the digestive system of 93 human immunodeficiency virus positive patients: an autopsy study

• Published in: Revista do Instituto de Medicina Tropical de São Paulo
• Main Authors: Lucinda Calheiros Guimarães, Ana Cristina Araujo Lemos Silva, Adilha Misson Rua Micheletti, Everton Nunes Melo Moura, Mario Leon Silva-Vergara, Sheila Jorge Adad
• Format: Article in Journal/Newspaper
• Language: English
• Published: Universidade de São Paulo (USP) 2012
• Subjects: Autopsy; Pathology; HIV; Acquired Immunodeficiency Syndrome; Digestive system; Gastrointestinal tract; Arctic medicine. Tropical medicine; RC955-962; Infectious and parasitic diseases; RC109-216; Arctic
• Online Access: https://doi.org/10.1590/S0036-46652012000200006; https://doaj.org/article/42e4802ebcf949cca57c5018784e71b9

Involvement of the digestive system in patients with acquired immunodeficiency syndrome (AIDS) is frequent and many changes in these patients are diagnosed only at autopsy. There are few studies of autopsy with detailed analysis of this system and only one was conducted in Brazil. We evaluated each segment of the digestive system in 93 consecutive autopsies of patients infected with human immunodeficiency virus (HIV) and the importance of these lesions to death. Of these, 90 (96.8%) patients had AIDS. We reviewed medical records, autopsy reports and histological sections from tongue to rectum stained with hematoxylin-eosin. When necessary, we analyzed special stains and immunohistochemistry to investigate infections. There was damage to the digestive system in 73 (78.5%) cases. The most common infections were candidiasis (42%), cytomegalovirus (29%), histoplasmosis (11.8%), toxoplasmosis (9.7%) and mycobacterial infection (9.7%). Malignancies were rare, present in four (4.3%) cases (two Kaposi's sarcoma, one adenocarcinoma and one metastatic embryonal carcinoma). All segments showed lesions: tongue (48.6%), esophagus (44.8%), stomach (44.7%), colon (43.2%) and small intestine (28.9%). The lesions found were immediate cause of death in five (5.4%) cases. In another 36 (38.7%) cases the basic disease was systemic and also compromised the digestive system.