title: Neuropathology of AIDS: An Autopsy Review of 284 Cases from Brazil Comparing the Findings Pre- and Post-HAART (Highly Active Antiretroviral Therapy) and Pre- and Postmortem Correlation.
abstract: A retrospective study of central nervous system (CNS) in 284 autopsy AIDS cases in Brazil (1989-2008) divided into 3 groups: A (without antiretroviral treatment: 163 cases); B (other antiretroviral therapies: 76 cases); C (HAART for 3 months or more: 45 cases). In 165 (58.1%) cases, relevant lesions were found, predominantly infections (54.2%); the most frequent was toxoplasmosis (29.9%) followed by cryptococcosis (15.8%), purulent bacterial infections (3.9%), and HIV encephalitis (2.8%); non-Hodgkin lymphomas occurred in 1.4% and vascular lesions in 1.1%. There was no difference when compared the frequency of lesion among the groups; however, toxoplasmosis was less common while HIV encephalitis was more frequent in group C related to A. CNS lesions remain a frequent cause of death in AIDS; however, the mean survival time was four times greater in group C than in A. In 91 (55.1%) of 165 cases with relevant brain lesions (or 32% of the total 284 cases), there was discordance between pre- and postmortem diagnosis; disagreement type 1 (important disease that if diagnosed in life could change the patient prognosis) occurred in 49 (53.8%) of 91 discordant cases (17.6% of the total 284) indicating the autopsy importance, even with HAART and advanced diagnostics technologies.
authors.affiliation: Discipline of Special Pathology, Universidade Federal do Triângulo Mineiro (UFTM), Avenida Getúlio Guaritá 130, 38025-440 Uberaba, MG, Brazil.
authors.forename: Ana Cristina Araújo Lemos
authors.initials: AC
authors.lastname: Silva
authors.forename: Blenda Sousa Carli
authors.initials: BS
authors.lastname: Rodrigues
authors.forename: Adilha Misson Rua
authors.initials: AM
authors.lastname: Micheletti
authors.forename: Sebastião
authors.initials: S
authors.lastname: Tostes
authors.forename: Antonio Carlos Oliveira
authors.initials: AC
authors.lastname: Meneses
authors.forename: Mário Leon
authors.initials: ML
authors.lastname: Silva-Vergara
authors.forename: Sheila Jorge
authors.initials: SJ
authors.lastname: Adad