Clinical and morphological features of adrenal cytomegalo virus lesion in HIV-infected patients

Abstract

Cytomegalovirus infection (CMV!) is high on the list ofsecondary diseases in patients with HIVinfection. Many aspects ofCMVI and a relationship ofthe morphological changes in the organs to the clinical manifestations ofthe disease remain to helessstudied. Despite the severity and high rate ofCMV-associated lesions in HIV-infected patients, data on the clinical and morphological characteristics ofthis pathology in the Russian literature are very scanty. The purpose of this study was to evaluate the morphologicalfeatures ofcytomegalovirus lesions ofthe adrenals in patients with HIV infection and to compare the findings with the clinical picture ofthe disease. In 1996 to 2000 an autoptic study was made of 95 deceased adult patients with HIV infection, 85 having its stage 11IB (AIDS). Adrenal CMVpathology was revealed in 42 patients. The paper presents morphological characteristics, points to the various sites, pattern, and extent ofa pathological process in the adrenals. Thefindings are compared with the clinical picture of the disease. Based on their clinical and morphological studies, the authors emphasize the staging nature ofa pathological process in the adrenals with a complete destruction ofthe organ's tissue ifadequate treatment is absent. Accordingly, it is suggested that if the clinical and laboratory signs of lower hormonalfunction ofthe adrenal cortex are detected in patients with CMVI, it is necessary to perform early etiotropic and replacement therapy that may arrest the process at early stages of its development.