       Document 0246
 DOCN  M9620246
 TI    The neuropathology and epidemiology of AIDS. A Berlin experience. A
       review of 200 cases.
 DT    9602
 AU    Martinez AJ; Sell M; Mitrovics T; Stoltenburg-Didinger G; Iglesias-Rozas
       JR; Giraldo-Velasquez MA; Gosztonyi G; Schneider V; Cervos-Navarro J;
       Freie Universitat Berlin, Universitatsklinikum Benjamin; Franklin,
       Germany.
 SO    Pathol Res Pract. 1995 Jun;191(5):427-43. Unique Identifier : AIDSLINE
       MED/96015364
 AB    The brains of 200 patients who died with Acquired Immunodeficiency
       Syndrome (AIDS) from Berlin were examined retrospectively. This study
       was specifically intended to evaluate and document the prevalence of
       neuropathologic abnormalities, establishing the frequency of the various
       types of structural lesions, their combinations, their relative
       incidence, and the risk factors involved in different age groups. The
       data were compared and contrasted with the findings reported from other
       parts of the world and other German cities. It was found that the mean
       age of this group of patients was 41.4 years old, 75% were
       homosexual/bisexuals (H/B) and 18.5% were drug abusers (DA). Only 5.5%
       were women. Brain parenchymal changes, called in this report,
       HIV-related encephalopathy (HIVRE), characterized by vacuolization or
       spongy changes and astrocytosis in the subcortical white matter, and
       occasionally in gray matter, were found in 67 patients (33.5%). Drug
       abusers had a higher incidence of HIVRE (59.5%) compared with
       homosexual/bisexuals (28%). This is statistically significant (p <
       0.0005). CMV encephalitis was found in 26 patients (13%) (8% of the drug
       abusers in contrast to 13% in the homosexual/bisexuals group). Primary
       central nervous system lymphoma (PCNSL) was seen in 28 patients (14%)
       regardless of the risk factor involved. 20 (13%) of the 150 H/B and 3
       (8%) of the 37 DA had CMV encephalitis. Of the 150 H/B, 24 (16%) had
       PCNSL compared with only 4 of 37 (11%) of the DA. A significant
       incidence of opportunistic infections, both protozoal and viral was
       found in all groups. Cerebral toxoplasmosis occurred in 68 patients
       (34%). Microglial (phagocytic) nodules, probably related to CMV or
       cerebral Toxoplasmosis, were observed in 40 cases (20%). Diffuse
       microglial proliferation was noted in 104 patients (52%). Cerebral
       cryptococcosis was found in three patients. Progressive multifocal
       leukoencephalopathy was seen in 16 patients (8%). Various combinations
       of CNS pathological processes were found in 44 of the patients (22%).
       These include concomitant infections with Toxoplasma gondii and HIVRE in
       13 patients; Toxoplasmosis and PCNSL in 8 patients; Toxoplasmosis with
       CMV and HIVRE in 4 patients; Toxoplasmosis with CMV in 2 patients;
       Toxoplasmosis with PCNSL and CMV in 2 patients; Toxoplasmosis with PCNSL
       and HIVRE in 2 patients and Toxoplasmosis with PML and HIVRE in 2
       patients; Cerebral CMV with PCNSL and HIVRE in 4 patients; Cerebral CMV
       with HIVRE in 2 patients; PML with PCNSL in one patient; PML with HIVRE
       in 2 patients; and PML with PCNSL and HIVRE in one patient.
       Cerebrovascular lesions were found in 34 patients (17%).(ABSTRACT
       TRUNCATED AT 400 WORDS)
 DE    Acquired Immunodeficiency Syndrome/COMPLICATIONS/EPIDEMIOLOGY/
       *PATHOLOGY  Adult  Aged  Aged, 80 and over  AIDS Dementia
       Complex/COMPLICATIONS/EPIDEMIOLOGY/*PATHOLOGY  AIDS-Related
       Opportunistic Infections/EPIDEMIOLOGY/ETIOLOGY/  PATHOLOGY
       Berlin/EPIDEMIOLOGY  Female  Human  Male  Middle Age  Retrospective
       Studies  Risk Factors  Support, Non-U.S. Gov't  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

