Postmortem findings and opportunistic infections in HIV-positive patients from a public hospital in Peru.
There is a paucity of HIV autopsy data from South America and none that document the postmortem findings in patients with HIV/AIDS in Peru. The purpose of this autopsy study was to determine the spectrum of opportunistic infections and the causes of mortality in HIV-positive patients at a public hospital in Lima. Clinico-epidemiological information regarding HIV infection in Peru is also reviewed. Sixteen HIV-related hospital postmortems, performed between 1999 and 2004, were included in this retrospective analysis. The primary cause of death was established in 12 patients: one died of neoplasia and 11 of infectious diseases, including 3 from pulmonary infection, 7 from disseminated infection, and 2 from central nervous system infection (one case had dual pathology). Opportunistic infections were identified in 14 cases, comprising cytomegalovirus, histoplasmosis, cryptococcosis, toxoplasmosis, Pneumocystis pneumonia, aspergillosis, tuberculosis, varicella zoster virus, and cryptosporidiosis. Fourteen patients had at least one AIDS-related disease that had been neither clinically suspected nor diagnosed premortem. Moreover, 82% of the diagnoses considered to be of important clinical significance had not been suspected antemortem. The spectrum and frequency of certain opportunistic infections differed from other South American autopsy studies, highlighting the importance of performing HIV/AIDS postmortems in resource-limited countries where locally specific disease patterns may be observed.
Eza
Dominique
D
Departamento de Laboratorio y Anatomía Patológica, Hospital Nacional Dos de Mayo, Parque Historia de la Medicina Peruana s/n, Altura de Cuadra 13 Avenida Grau, Lima 1, Perú. dominiqueeeza@yahoo.co.uk
Cerrillo
Gustavo
G
Moore
David A J
DA
Castro
Cecilia
C
Ticona
Eduardo
E
Morales
Domingo
D
Cabanillas
Jose
J
Barrantes
Fernando
F
Alfaro
Alejandro
A
Benavides
Alejandro
A
Rafael
Arturo
A
Valladares
Gilberto
G
Arevalo
Fernando
F
Evans
Carlton A
CA
Gilman
Robert H
RH
D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology* / Q000209:etiology; D000328:Adult; D000368:Aged; D001344:Autopsy; D002423:Cause of Death; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000401:mortality*; D006779:Hospitals, Public / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D010568:Peru / Q000453:epidemiology; D012189:Retrospective Studies