Neuropathology of human immunodeficiency virus 1 infection. Significance of studying in forensic autopsy cases at Dar es Salaam, Tanzania.
OBJECTIVE
In sub-Saharan Africa, only a few studies of neurologic complications of human immunodeficiency virus 1 (HIV-1) infection have been done. The authors studied neuropathology of HIV-1 infection in Tanzania.


METHODS
Forensic autopsy study at Dar es Salaam, Tanzania.


METHODS
A joint research project between Dar es Salaam, Tanzania, and Kumamoto, Japan.


METHODS
Thirty patients with risk factors for HIV-1 infection.


METHODS
Human immunodeficiency virus 1 infection was evaluated by HIV-1 antibody test on postmortem serum samples. The brains of HIV-1-infected persons were studied histopathologically.


RESULTS
Infection with HIV-1 was identified on postmortem serum samples in 10 of 30 forensic autopsy cases. Neuropathologic changes of the brain were observed in 8 of the 10 HIV-1-infected persons; these changes consisted of lymphocytic meningitis, bacterial meningoencephalitis, cryptococcal meningoencephalitis, tuberculous meningitis with brain abscesses, and intracerebral hemorrhage.


CONCLUSIONS
Because none of the persons studied was suspected to have had brain diseases before autopsy, the results suggest that brain diseases of HIV-1-infected patients are likely to go unrecognized in Tanzania. In addition, the high incidence of neuropathologic findings in HIV-1-infected persons indicates that HIV-1-related brain diseases are common in Tanzania, as they are in developed countries. Further forensic autopsy study will determine the range and prevalence of brain complications and have immediate impact on the management of HIV-1-infected patients in Tanzania and other developing countries.
Kibayashi
K
K
Department of Forensic Medicine, Kumamoto University School of Medicine, Kumamoto, Japan.
Ng'walali
P M
PM
Mbonde
M P
MP
Makata
A M
AM
Mwakagile
D
D
Harada
S
S
Kitinya
J N
JN
Tsunenari
S
S
D015526:AIDS Dementia Complex / Q000276:immunology / Q000473:pathology; D017088:AIDS-Related Opportunistic Infections / Q000276:immunology / Q000473:pathology; D000293:Adolescent; D000328:Adult; D001921:Brain / Q000473:pathology*; D001927:Brain Diseases / Q000276:immunology / Q000473:pathology*; D005554:Forensic Medicine; D015483:HIV Antibodies / Q000032:analysis; D015658:HIV Infections / Q000276:immunology / Q000473:pathology*; D015497:HIV-1; D006801:Humans; D016483:Lymphoma, AIDS-Related / Q000276:immunology / Q000473:pathology; D008297:Male; D016920:Meningitis, Bacterial / Q000276:immunology / Q000473:pathology; D008590:Meningoencephalitis / Q000276:immunology / Q000473:pathology; D008875:Middle Aged; D013636:Tanzania
D015483:HIV Antibodies