SIDA en niños y adolescentes. Un estudio de 34 autopsias en dos décadas.

Background. Autopsy studies in patients who died with AIDS provide an insight on the occurrence and diversity of tissue changes directly resulting from HIV infection and of the infectious complications, often with opportunistic organisms, associated with the disease. Material and methods. This is a retrospective analysis of 34 autopsies performed in children dying with AIDS at the National Institute of Pediatrics in Mexico City from 1985 to 2004. The cases were classified according to the mechanisms of infection in maternal (prenatal and from breast feeding), transfusion related and from sexual contact. For comparative purposes, the cases were distributed in two decades based on the probable date of infection. Results. Involvement of the lymphoid tissue was the most frequent primary pathology (79%) followed by central nervous system disease in 24 cases (70%). Associated pathology included malnutrition (53%), nephropathy (11.7%), blood vessel involvement (5.8%) and hepatitis (2.9%). Secondary infection was present in every case. Infectious agents included bacteria (55.8%), Cytomegalovirus (44.15%), Pneumocystis (26.4%), Candida (23%), Herpes/Varicella (20%) and Histoplasma (14.7%). Conclusions. A wide variety of tissue changes directly related to HIV infection was found, some of them infrequent complications such as vasculitis. Histoplasmosis was an important cause of death and was not considered as a clinical diagnosis in any of our cases. Mycobacteria, probably non-tuberculous, were found in two patients. Pulmonary Pneumocystis infection is persistently frequent in spite of clinical awareness and prophylactic measures [ABSTRACT FROM AUTHOR]