Autopsy findings on patients with AIDS in Taiwan.

C H Hsiao, S H Huang, S F Huang, C L Song, I J Su, C Y Chuang, Y T Yao, C T Lin, H C Hsu
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Abstract

At National Taiwan University Hospital, from 1986 to 1996, autopsies were performed on 16 patients with acquired immunodeficiency syndrome. There were 15 men and 1 woman. Fourteen of these male patients had contracted the disease as a result of sexual practice, among which 9 were homosexual, 1 was bisexual and 4 were heterosexual. One of the patients had become infected by sharing a syringe during intravenous drug use. The female was a sex worker. Among these patients, only 2 had been tested for HIV before developing AIDS. On autopsy, lymphoid depletion and thymus atrophy were found in all patients. Testicular atrophy was noted in all the male patients. Three patients died of malignant lymphoma. Twelve patients died of opportunistic infections and 1 committed suicide. The initial opportunistic infection was usually oral candidiasis. Pneumocystis carinii pneumonia (PCP) was the most common opportunistic infection developed in the early stage while cytomegalovirus (CMV) infection was the most common one found in the late stage. Mycobacterium infection had developed in 8 patients. Six patients had disseminated Kaposi's sarcoma (KS) and 4 of them were homosexual. In 4 patients, biopsy specimens were proved to have KS associated viral (HHV-8) genome. Malignant lymphoma was found in 4 cases, all were of high grade B cell type. Epstein-Barr virus (EBV) encoding small RNA (EBER1) was demonstrated in all the lymphomas. In conclusion, (1) the prevalence of tuberculosis (38%) in patients with AIDS in Taiwan is high; (2) the most common opportunistic infections in this series are candidiasis, PCP and CMV infections; (3) the incidence of AIDS related non-Hodgkin's lymphoma in Taiwan has increased since 1995.

台湾艾滋病患者的尸检结果。
在国立台湾大学医院,从1986年到1996年,对16名获得性免疫缺陷综合征患者进行了尸检。有15名男性和1名女性。其中14例男性患者因性行为感染该病,其中同性恋9例,双性恋1例,异性恋4例。其中一名患者因在静脉注射毒品时共用一个注射器而感染。这名女性是一名性工作者。在这些患者中,只有2人在患艾滋病之前接受过艾滋病毒检测。尸检发现所有患者均出现淋巴细胞减少和胸腺萎缩。所有男性患者均有睾丸萎缩。3例患者死于恶性淋巴瘤。12名患者死于机会性感染,1名患者自杀。最初的机会性感染通常为口腔念珠菌病。卡氏肺囊虫肺炎(PCP)是早期最常见的机会感染,而巨细胞病毒(CMV)感染是晚期最常见的机会感染。8例患者发生分枝杆菌感染。弥散性卡波西肉瘤(KS) 6例,其中4例为同性恋。在4例患者中,活检标本被证明具有KS相关病毒(HHV-8)基因组。恶性淋巴瘤4例,均为高分级B细胞型。所有淋巴瘤均可见编码小RNA (EBER1)的eb病毒(EBV)。综上所述:(1)台湾地区艾滋病患者结核病患病率较高(38%);(2)该系列中最常见的机会性感染是念珠菌病、PCP和CMV感染;(3)台湾地区AIDS相关非霍奇金淋巴瘤发病率自1995年以来呈上升趋势。
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