AIDS and the pancreas in the HAART era: a cross sectional study

International Archives of Medicine

Fernando LA Fonseca²  Ana A Mader¹  Marcelo R Bacci³  Ethel Z Chehter²  Alexandre G Barbosa² 

[1] Department of Pathology, Faculdade de Medicina do ABC, Santo André, Brazil;Department of Gastroenterology, Faculdade de Medicina do ABC, Santo André, Brazil;Department of General Practice, Faculdade de Medicina do ABC, Santo André, Brazil

关键词: Chronic pancreatitis;    Highly active anti-retroviral therapy;    Exocrine pancreatic insufficiency;    HIV;   

Others  :  803106
DOI  :  10.1186/1755-7682-6-28

 received in 2013-04-06, accepted in 2013-07-09,  发布年份 2013

【 摘 要 】

Backgrounds

The aim of this study is identify the main morphological patterns of the pancreas in AIDS patients in use of Higly Active Antiretorviral Therapy (HAART).

Methods

We conducted a cross sectional study in the year of 2010. The inclusion criteria were patients older than 18 years who died of AIDS with the use of HAART (2006–2009) and underwent to autopsy . They were compared with a group of 109 patients who died of AIDS in 1995 before the HAART therapy. All the autopsies were made in the Death Verification Service of São Paulo.

Results

The HAART group presented pancreas abnormalities lighter than no HAART users. In the HAART group, histology shows: reduction of zymogen granules in the acinar cells (ZG) higher percentage of cases, “dysplasia-like” presents lower and pancreatic acinar atrophy, presents higher percentage of cases compared to no HAART group. The exocrine pancreas in treated patients was distinguished by the high level of atrophy, sharp reduction of zymogen granules and high level of apoptosis, reflecting degeneration and lower level of protein-caloric malnutrition.

Conclusions

The islets of Langerhans in HAART group were increased in number and volume and with high level of nuclear dysplasia. The antiviral therapy and a longer survival resulted in a higher atrophy and reduction of enzymes, increasing the apoptosis and generated important changes in the pancreatic islets, probably resulting in clinical laboratory repercussion.

We found no evidence of pancreatic histopathological lesions secondary to antiretroviral therapy.

【 授权许可】

   
2013 Barbosa et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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