Liver Pathology in Children With Aids: A Comparison Between the South American and North American Population

Abstract

& Liver tissue from autopsies of twenty-nine cases of children with AIDS were collected from three major South America (SA) pediatric hospitals. The hepatopathologic ® ndings were classi® ed in the same fashion as in a series of sixty-one children with AIDS from North America (NA): in¯ammation, non-speci® c, lymphoproliferative disorders, and giant cell transformation. By comparing both groups, we noted that the SA children were younger at time of death consistent with a more rapid progression of the disease. Opportunistic infections varied with a higher prevalence of Cytomegalovirus (CMV) infection in SA children. The histopathologic features of CMV in the liver of SA children were associated with a conspicuous in¯ammation absent in the NA group. Finally, diÚ erent non-speci® c hepatic changes were found in SA children, including one case of peliosis hepatis.Many histologic alterations are associated with symptomatic human immuno-de® ciency virus (HIV) infection. Some are related directly to the virus, others are secondary to the immunode® ciency status such as neoplasms and opportunistic infections, or toxic eÚ ects due to therapy. 542 R. A. Morotti et al.FIGURE 4. Peliosis hepatis characterized by a nodular mass with ectatic sinusoids. Hematoxylin-eosin X250.Liver Pathology in Children with AIDS 545