Salivary gland disease in HIV/AIDS and primary Sjögren's syndrome: analysis of collagen I distribution and histopathology in American and African patients.
BACKGROUND
Salivary gland disease (SGD) in HIV/AIDS is clinically and histopathologically very similar to Sjögren's Syndrome (SS), although the mechanism of tissue damage is unknown. The aim of this study is to determine the prevalence of SGD in primary SS and in HIV/AIDS in USA and in West African patients, and to seek distinguishing histopathologic features that may help to elucidate underlying mechanisms.


METHODS
Histologic sections of minor salivary glands from 164 HIV-positive and -negative patients from Cameroon and the US, and from 17 US patients with primary SS, were evaluated following salivary gland biopsy for inflammatory changes. To confirm the presence of fibrosis, collagen I, which is the most abundant collagen type, was assessed immunohistochemically in H&E-stained sections.


RESULTS
Forty-eight per cent of patients with HIV from Cameroon had severe SGD, while it was only in 6% of patients from the US. Patients with HIV in the US had less fibrosis and collagen I deposits than Cameroonians. Seventy-six per cent of US HIV-positive patients had received anti-retroviral therapy, while none of the African patients had. SS and AIDS patients had a tendency for lymphocytes to locate in a perivascular rather than in a periductal distribution.


CONCLUSIONS
The prevalence of SGD and the presence of fibrosis and collagen I in Cameroonians with HIV is significantly higher than in HIV-positive American patients, and is similar to US patients with primary SS. The impact of patient selection, anti-retroviral therapy, and pathogenic mechanisms on salivary gland pathology is discussed.
McArthur
Carole P
CP
Department of Pathology, Truman Medical Center, and University of Missouri, Kansas City, USA. mcarthurc@umkc.edu
Africa
Charlene W J
CW
Castellani
William J
WJ
Luangjamekorn
Nida J
NJ
McLaughlin
Matthew
M
Subtil-DeOliveira
Antonio
A
Cobb
Charles
C
Howard
Paul
P
Gustafson
Steven
S
Palmer
Dennis
D
Miranda
Roberto N
RN
D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy / Q000473:pathology*; D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D001706:Biopsy; D002163:Cameroon; D002648:Child; D024042:Collagen Type I / Q000032:analysis*; D005260:Female; D005355:Fibrosis; D015658:HIV Infections / Q000188:drug therapy / Q000473:pathology*; D018023:HIV Seronegativity; D006679:HIV Seropositivity / Q000473:pathology; D006801:Humans; D008214:Lymphocytes / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012466:Salivary Gland Diseases / Q000473:pathology* / Q000821:virology; D012470:Salivary Glands, Minor / Q000473:pathology; D012859:Sjogren's Syndrome / Q000473:pathology*; D014481:United States
D019380:Anti-HIV Agents; D024042:Collagen Type I