title: Morphological changes in the digestive system of 322 necropsies of patients with acquired immune deficiency syndrome: comparison of findings pre- and post-HAART (Highly Active Antiretroviral Therapy).
abstract: Involvement of the digestive system in AIDS pathologies or injuries is frequent. Aiming at comparing the frequency, the importance that these lesions have for death and the survival time in patients using or not using HAART, we studied 322 necropsies classified as follows: Group A - without antiretroviral drugs (185 cases); B - one or two antiretroviral drugs or HAART for less than six months (83 cases); C - HAART for six months or longer (54 cases). In the overall analysis of the digestive system, changes were present in 73.6% of cases. The most frequent was Candida infection (22.7%), followed by cytomegalovirus (19.2%), Histoplasma capsulatum (6.5%), mycobacteria (5.6%), and Toxoplasma gondii (4.3%). T. gondii infection was more frequent in group A compared with group C, and cytomegalovirus (CMV) was more frequent in group A compared with groups B and C (p < 0.05); 2.2% of the deaths were due to gastrointestinal bleeding. Regarding the segments, only in the large intestine, and only cytomegalovirus, were more frequent in group A compared with group C. We conclude that digestive system infections are still frequent, even with the use of HAART. However, the average survival time in group C was more than three times greater than the one in group A and nearly double that of group B, demonstrating the clear benefit of this therapy.
authors.affiliation: Universidade Federal do Triângulo Mineiro, Departamento de Patologia Especial, Uberaba, Minas Gerais, Brazil.
authors.forename: Lucinda Calheiros
authors.initials: LC
authors.lastname: Guimarães
authors.affiliation: Universidade Federal do Triângulo Mineiro, Departamento de Patologia Especial, Uberaba, Minas Gerais, Brazil.
authors.forename: Ana Cristina Araújo Lemos da
authors.initials: AC
authors.lastname: Silva
authors.affiliation: Universidade Federal do Triângulo Mineiro, Departamento de Patologia Especial, Uberaba, Minas Gerais, Brazil.
authors.forename: Adilha Misson Rua
authors.initials: AM
authors.lastname: Micheletti
authors.affiliation: Universidade Federal do Triângulo Mineiro, Departamento de Patologia Especial, Uberaba, Minas Gerais, Brazil.
authors.forename: Everton Nunes Melo
authors.initials: EN
authors.lastname: Moura
authors.affiliation: Universidade Federal do Triângulo Mineiro, Departamento de Patologia Especial, Uberaba, Minas Gerais, Brazil.
authors.forename: Mario Léon
authors.initials: ML
authors.lastname: Silva-Vergara
authors.affiliation: Universidade Federal do Triângulo Mineiro, Departamento de Patologia Especial, Uberaba, Minas Gerais, Brazil.
authors.forename: Sebastião
authors.initials: S
authors.lastname: Tostes
authors.affiliation: Universidade Federal do Triângulo Mineiro, Departamento de Patologia Especial, Uberaba, Minas Gerais, Brazil.
authors.forename: Sheila Jorge
authors.initials: SJ
authors.lastname: Adad
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000401:mortality / Q000473:pathology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D019380:Anti-HIV Agents / Q000008:administration & dosage*; D023241:Antiretroviral Therapy, Highly Active; D001344:Autopsy; D004064:Digestive System / Q000382:microbiology / Q000469:parasitology / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents