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Pathology- Human Immunodeficiency Virus
Pathogen
• Enveloped RNA virus with a single-stranded, positive-sense genome. • Belongs to the lentivirus genus within the retrovirus family.
Epidemiology
• Prevalent globally, particularly in Sub-Saharan Africa. • Designated as a pandemic by the World Health Organization (WHO).
Transmission
• Primary transmission pathways include unprotected sexual intercourse, infected needles, breast milk, and maternal transmission during childbirth
. • Transmission through transfused blood products has been nearly eradicated due to rigorous donor screening protocols.
Immunopathogenesis
• Infects CD4+ helper T lymphocytes, macrophages, and dendritic cells. • Extensive dissemination of lymphoid tissue transpires post-infection. • HIV-specific CD8+ cytotoxic T-cells initially manage the disease. • Subsequently, HIV evades immunological regulation via antigenic mutation. • Viral load escalates fast while CD4+ numbers decline sharply.
Presentation
• Acute seroconversion induces a flu-like disease characterized by fever, lymphadenopathy, pharyngitis, myalgia, rash, and oral ulcers. The latency phase subsequently ensues, typically remaining asymptomatic. The last phase is characterized by opportunistic infections and/or neoplasm. Common infections encompass bacterial pneumonia,pulmonary tuberculosis,Pneumocystis pneumonia, oesophageal candidiasis, cryptosporidiosis, Mycobacterium avium in the colon,cryptococcal meningitis, and cerebral toxoplasmosis.
Common neoplasms encompass cervical and anal warts, carcinoma, non-Hodgkin B-cell lymphomas, and Kaposi's sarcoma.
Histopathology
• Lymph nodes exhibit pronounced follicular proliferation accompanied by follicle lysis. Lymphomas are typically of the diffuse big B-cell variety.
• The bone marrow exhibits dysplasia characterized by disorganization of hematopoietic lineages and an elevated count of plasma cells.
• The skin may present with eosinophilic folliculitis, indicating infiltration of hair follicles by eosinophils. Cutaneous Kaposi's sarcoma exhibits an erratic proliferation of HHV-8-positive spindle cells inside the dermis, resulting in the formation of slit-like vascular gaps. Pneumocystis pneumonia is characterized by lymphocytic alveolitis accompanied by silver-positive organisms in the alveolar spaces. Prognosis: With contemporary anti-HIV medicine, numerous individuals can anticipate a lifespan approaching normalcy, resulting in death with HIV rather than from it.
Pathogen
• Enveloped RNA virus with a single-stranded, positive-sense genome. • Belongs to the lentivirus genus within the retrovirus family.
Epidemiology
• Prevalent globally, particularly in Sub-Saharan Africa. • Designated as a pandemic by the World Health Organization (WHO).
Transmission
• Primary transmission pathways include unprotected sexual intercourse, infected needles, breast milk, and maternal transmission during childbirth
. • Transmission through transfused blood products has been nearly eradicated due to rigorous donor screening protocols.
Immunopathogenesis
• Infects CD4+ helper T lymphocytes, macrophages, and dendritic cells. • Extensive dissemination of lymphoid tissue transpires post-infection. • HIV-specific CD8+ cytotoxic T-cells initially manage the disease. • Subsequently, HIV evades immunological regulation via antigenic mutation. • Viral load escalates fast while CD4+ numbers decline sharply.
Presentation
• Acute seroconversion induces a flu-like disease characterized by fever, lymphadenopathy, pharyngitis, myalgia, rash, and oral ulcers. The latency phase subsequently ensues, typically remaining asymptomatic. The last phase is characterized by opportunistic infections and/or neoplasm. Common infections encompass bacterial pneumonia,pulmonary tuberculosis,Pneumocystis pneumonia, oesophageal candidiasis, cryptosporidiosis, Mycobacterium avium in the colon,cryptococcal meningitis, and cerebral toxoplasmosis.
Common neoplasms encompass cervical and anal warts, carcinoma, non-Hodgkin B-cell lymphomas, and Kaposi's sarcoma.
Histopathology
• Lymph nodes exhibit pronounced follicular proliferation accompanied by follicle lysis. Lymphomas are typically of the diffuse big B-cell variety.
• The bone marrow exhibits dysplasia characterized by disorganization of hematopoietic lineages and an elevated count of plasma cells.
• The skin may present with eosinophilic folliculitis, indicating infiltration of hair follicles by eosinophils. Cutaneous Kaposi's sarcoma exhibits an erratic proliferation of HHV-8-positive spindle cells inside the dermis, resulting in the formation of slit-like vascular gaps. Pneumocystis pneumonia is characterized by lymphocytic alveolitis accompanied by silver-positive organisms in the alveolar spaces. Prognosis: With contemporary anti-HIV medicine, numerous individuals can anticipate a lifespan approaching normalcy, resulting in death with HIV rather than from it.
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