Correlation between the morphological signs of tuberculosis and the immune status in HIV infection

Abstract

Comprehensive morphological examination of surgical and biopsy samples from 148 patients and autopsy specimens from 181 deceased persons was made to determine a correlation between the level of immunosuppression and the microscopic signs of tuberculosis in patients with HIV-associated tuberculosis (HIV/TB). A relation was found between the count of CD4+ lymphocytes and the predominant type of a tissue inflammatory reaction. Insidious granulomatous inflammation and a preponderance of alterative and exudative components in the foci of tuberculous inflammation suggested that a delayed-type hypersensitivity response that was typical of tuberculosis gave way to an immediate-type hypersensitivity response and reflected severe immune system dysfunction. The lack of responsiveness of the macroorganism in the virtually complete absence of CD4+ lymphocytes observed during autopsy examination led to the acute progression and generalization of tuberculosis, by affecting all organs and systems.

Keywords

• вич-инфекция
• туберкулез
• патологическая анатомия
• иммуносупрессия