Euro Virology & STD-HIV AIDS 2019: HIV Infection and its complications from pathologist’s point of view - Vsevolod A Zinserling – Saint - Petersburg University
HIV infection remains one in all the foremost dangerous diseases and vital causes of death. various investigations square measure dedicated to issues of medical specialty, biological science, treatment, science etc. the quantity of studies discussing the results of pathological studies is extremely restricted. Having long run expertise in HIV pathology, we are able to formulate the subsequent things. most significant inquiries to be studied on the autopsies of the deceased from HIV-infection: precise list of secondary infections and tumors with specification of their localization; analysis of the efficaciousness of treatment; revealing of immediate death cause; assortment of specimen for more investigations so as to check the mechanisms of the sickness and its complications. ways counselled for post-mortem investigation square measure elaborated histologic study of all macroscopically modified and not modified organs with use of bound special staining; medicine and mycological investigation of all suspected lesions so as to clarify their Etiology and bound properties of the pathogens; totally different medicine, molecular-biological ways and assay so as to check the localization of lesions because of HIV and alternative viruses and a few of their properties. Among the foremost fascinating, vital and not sufficiently known changes we tend to pay special attention to the brain. we have got to differentiate direct and indirect lesions because of HIV virus itself, alternative pathogens (CMV, Toxoplasma, Cryptococcus, HSV, JCV, herpes virus 1st of all) and alternative influences and follow up them in numerous decades of epidemics.
Some clinic-pathological correlations in perinatal HIV: infective agent load in pregnant ladies correlate with the depth of immunological disorder; ladies while not antiretroviral treatment had additional expressed grade of immunosuppression; frequency of secondary septic inflammation correlate with the grade of immunosuppression. Main probable unhealthful mechanisms of Placenta lesion in HIV: direct lesions of placenta macrophages (Hoffbauer cells), endotheliocytes and decidual cells with development of typical changes of nuclei, leading role endotheliocytes and decidual cells with development of typical changes of nuclei, leading role in inflammatory reaction of CD14+ as compared with CD68+ cells; disturbance of growing because of hyper expression of anti-angiogenic issue TGF?; probable disturbances of syncytial-capillary membrane. Main queries for more investigations: informative incidence and Etiology of placenta inflammation and intrauterine infections in ladies with HIV; more studies of mechanisms of placenta lesions in HIV infected women; clinic-pathological correlations between morphological changes in placenta and outcome of maternity versus antiretroviral treatment; Clinico-pathological correlations between symptoms in kids from HIV-infected mothers and post-mortem histology; finding out impact of antepartum infections on development of kids and morbidity of teenagers and adults.
Question for the life-time pathological and biological science medical specialty square measure study of smears or liquid biopsies of bodily fluid for evaluating mycobacteria, cryptococci and tumor cells, lymphatic tissue biopsies so as to spot the origin of their lesion, needle biopsies of alternative organs because of clinical necessity. Infection with the human immunological disorder virus (HIV) causes general T cell destruction and reduced cell‐mediated immunity that results in a large vary of expedient infections and cancers. Second, it directly damages several tissues – gut, brain, respiratory organ – through mononucleate cell infection and activation. Third, through immune activation and effects on endothelia, it will cause additional refined general organ harm, like chronic vas, hepatic, pneumonic and central system nervous sickness. Antiretroviral treatment has enabled
HIV ‐infected persons to measure with chronic infection, although with some side‐effects and mortality, additionally as reactions because of the immune reconstitution inflammatory syndrome (IRIS). As cohorts of infected individuals become older, age‐related diseases can mix with chronic HIV infection to supply disabilities whose scale is not nevertheless understood. HIV is detectable in tissues by assay once infection hundreds square measure high, like initially presentation. Pathologists ought to proactively think about HIV sickness in routine diagnostic work, therefore on determine additional HIV ‐infected patients and modify their optimum management. HIV sickness has been pandemic for quite thirty years, although the viruses were transmitted from chimpanzees and monkeys to man concerning one hundred years past one. a colossal quantity of knowledge on its history, pathologic process and clinical pathology has been gathered, with new insights still rising two. while the while associations of expedient infections and tumors with immunological disorder square measure well delineated three, HIV infection as such affects each organ system in complicated ways in which, in the least ages from the new-born to the old. As antiretroviral treatment (ART) is given to ever larger proportions of these with HIV infection, and is life‐extending however not curative four, interest has touched on to the outcomes of the interactions of HIV, anti‐retroviral medical care and also the ageing method, and the way to manage the growing variety of persons with variety HIV infection.