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HIV-1/AIDS Neuropathology in a Canadian Teaching Centre

Published online by Cambridge University Press:  16 February 2016

Kimberley Walsh ,
William Thompson ,
Joseph Megyesi ,
Clayton A. Wiley  and
Robert Hammond
Kimberley Walsh
Affiliation:
Departments of Pathology, London Health Sciences Centre and University of Western Ontario, Canada
William Thompson
Affiliation:
St. Joseph's Health Centre and London HIVCare Programme, University of Western Ontario, Canada
Joseph Megyesi
Affiliation:
Departments of Pathology, London Health Sciences Centre and University of Western Ontario, Canada Clinical Neurological Sciences, London Health Sciences Centre and University of Western Ontario, Canada
Clayton A. Wiley
Affiliation:
Department of Pathology (Division of Neuropathology), University of Pittsburgh, Pittsburgh, PA, USA
Robert Hammond*
Affiliation:
Departments of Pathology, London Health Sciences Centre and University of Western Ontario, Canada Clinical Neurological Sciences, London Health Sciences Centre and University of Western Ontario, Canada
*
Department of Pathology, London Health Sciences Centre, 339 Windermere Road, London, ON, Canada N6A5A5
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Abstract

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Background:

The nervous system is a major target of HIV-1 infection and site of many complications of AIDS. Most of our knowledge pertaining to the range and frequency of neuropathology in HIV-1/AIDS is from large centres outside Canada in different social and health care settings. The goal of the present study was to describe HIV-1/AIDS-associated neuropathology before and during the era of highly active antiretroviral therapy at a Canadian teaching centre.

Methods:

The records of the Department of Pathology, London Health Sciences Centre were electronically searched for cases of HIV-1/AIDS that came to postmortem examination since 1985. The clinical records and pathological materials were reviewed.

Results:

Sixteen autopsies of HIV-1/AIDS were identified. All patients were male. Fourteen contracted HIV-1 through high risk homosexual activity, one through the transfusion of blood products and one through intravenous drug use. Three patients (19%) had pre-mortem evidence of HIV-1 associated dementia. At autopsy, 12 of the 16 cases had neuropathological findings and the most common diagnoses were HIV-1 encephalitis, progressive multifocal leukoencephalopathy, toxoplasmosis, and primary CNS lymphoma.

Conclusions:

High risk homosexual activity was a more prominent factor in acquiring AIDS in cases coming to postmortem examination compared with previous reports from most larger urban centres outside Canada where injection drug use and high risk heterosexual activity factored prominently. The incidence of HIV-1 associated dementia was similar to that reported previously. This study confirms the heavy burden and wide spectrum of disease experienced by the nervous system in HIV-1/AIDS.

Type
Original Article
Information
Canadian Journal of Neurological Sciences , Volume 31 , Issue 2 , May 2004 , pp. 235 - 241
Copyright
Copyright © The Canadian Journal of Neurological 2004

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