Comparative brain pathology of HIV-seronegative and HIV-infected drug addicts.
Early stages of infection with human immunodeficiency virus (HIV) were studied in HIV-seropositive drug addicts. Since heroin users are immunocompromized even in the absence of HIV infection, the aim of the present study was to compare the morphological alterations present in HIV-seronegative and HIV-seropositive drug addicts. A total of 60 cases (32 HIV-seronegative subjects, 21 HIV-seropositive patients without signs of acquired immunodeficiency syndrome (AIDS), and 7 HIV-seropositive patients with signs of AIDS) were investigated macroscopically, histologically, and immunohistochemically HIV-seronegative patients presented more frequently with acute drug intoxication, died at a significantly younger age than HIV-seropositive patients, and were found to suffer more frequently from alcohol-related changes. These results indicated that HIV-seronegative and HIV-seropositive patients differed possibly in their drug consumption and also in their general conditions of life. In accordance with previous reports activated microglia and a diffuse astrogliosis in the white matter were detected at a significantly higher frequency and found to be more severe in HIV-seropositive subjects than in HIV-seronegative addicts. A lymphocytic meningitis was present in 6 of 21 HIV-seropositive patients but in none of the HIV-seronegative patients. Perivascular infiltrates consisting of lymphocytes and macrophages were detected at similar frequencies in HIV-seronegative and HIV-seropositive patients but were significantly more severe in patients suffering from lymphocytic meningitis or purulent encephalitis. Opportunistic infections were only demonstrated in 2 AIDS cases. In 10 of the HIV-seronegative patients and in 3 of the HIV-seropositive patients CD68-and Ham56-positive multinucleated cells were detected scattered in the subarachnoidal space exclusively over the frontal cortex.
Makrigeorgi-Butera
M
M
Department of Neuropathology, University of Hamburg, Germany.
Hagel
C
C
Laas
R
R
Puschel
K
K
Stavrou
D
D
D000163:Acquired Immunodeficiency Syndrome / Q000473:pathology; D000293:Adolescent; D000328:Adult; D001921:Brain / Q000473:pathology*; D005260:Female; D015658:HIV Infections / Q000473:pathology*; D018023:HIV Seronegativity / Q000187:drug effects*; D006679:HIV Seropositivity / Q000473:pathology*; D006801:Humans; D013287:Illicit Drugs / Q000633:toxicity; D008297:Male; D008875:Middle Aged; D019966:Substance-Related Disorders / Q000473:pathology*
D013287:Illicit Drugs