Clinical Profile of HIV-related Aneurysms

Abstract

HIV related aneurysms are characterised by their predilection for young patients, multiplicity, atypical location and their distinct histological features. Their increasing frequency reflects the unchecked advance of the HIV epidemic.

Anaesthesia for vascular procedures:How do South African patients differ?

“…28 Similarly, cardiac death was attributed to AMI in 67% of patients in the South African study, 4 and 66% of patients in the predominantly American and European studies. 28 However, if the analysis is conducted only on patients of age >39 years, in order to remove the majority of trauma (mean age of 28.7 (± 9.2) years) and HIV-related vascular patients (median age 30 to 40 years), [30][31][32] then the all-cause mortality rises to 10.8% and the cardiac mortality to 4.4% (see Table II) (Biccard, unpublished).…”

Ruptured Mycotic Aortic Aneurysm Secondary to Escherichia Coli Bacteremia in an HIV-Positive Patient

“…The patient's HIV has been well-controlled on HAART therapy with Genvoya (Elvitegravir, Cobicistat, Emticitabine, Tenofovir Alafenamide), with recent CD4 count of 524/mm 3 and an undetectable viral load. On physical exam, he had mild abdominal and flank tenderness as well as palpable femoral pulses.…”

“…His white blood disease, and aneurysm formation. HIV-related aneurysms often occur in multiple and atypical locations, preferentially affecting the carotid and superficial femoral arteries [1,3,14]. Typical histologic features include leukocytoclastic vasculitis of the vasa vasora and periadventitial vessels, chronic inflammation, and medial fibrosis with loss of elastic and muscular tissue [3,15].…”

“…HIV-related aneurysms often occur in multiple and atypical locations, preferentially affecting the carotid and superficial femoral arteries [1,3,14]. Typical histologic features include leukocytoclastic vasculitis of the vasa vasora and periadventitial vessels, chronic inflammation, and medial fibrosis with loss of elastic and muscular tissue [3,15]. While the etiology of HIV-related aneurysms remains unclear, it has been hypothesized that immunosuppression in HIV-positive patients makes them more susceptible to bacteremia and secondary mycotic aneurysm formation [1,2].…”

“…HIV-related aneurysmal disease has been shown to be a distinct pathologic entity from atherosclerotic and mycotic aneurysms [3] and can be distinguished by several features-the presence of multiple aneurysms in atypical locations, younger patient age, fewer traditional atherosclerotic risk factors, and unique histopathology defined by peri-adventitial inflammatory infiltrates [4][5][6][7][8]. It remains unclear to what extent direct viral action versus opportunistic bacterial infection is responsible [2].…”