Morphological and immunological changes in the skin of autopsied women with AIDS

Silva, Renata Beatriz; Rocha, Laura Penna; Souza, Laís Resende Cardoso de; Faria, Humberto Aparecido; Olegário, Janaínna Grazielle Pacheco; Soares, Maria Helena; Ferraz, Mara Lúcia Fonseca; Corrêa, Rosana Rosa Miranda; Teixeira, Vicente de Paula Antunes; Cavellani, Camila Lourencini

doi:10.1007/s00428-012-1297-9

Cited by 5 publications

(6 citation statements)

References 43 publications

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“…8 In a nonhuman primate model of HIV-SN, animals with the most severe disease showed a decrease in corneal nerve fiber density, 9 and IVCCM has demonstrated a reduction in corneal nerve fiber length in HIV-positive patients. 10 Epidermal Langerhans cell (LC) density is reduced in patients with HIV or AIDS, 11 but in vivo assessment of corneal LC density has not been reported in HIV.…”

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confidence: 99%

Use of Corneal Confocal Microscopy to Evaluate Small Nerve Fibers in Patients With Human Immunodeficiency Virus

et al. 2017

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IMPORTANCEObjective quantification of small fiber neuropathy in patients with human immunodeficiency virus (HIV)-associated sensory neuropathy (HIV-SN) is difficult but needed for diagnosis and monitoring. In vivo corneal confocal microscopy (IVCCM) can quantify small fiber damage.OBJECTIVE To establish whether IVCCM can identify an abnormality in corneal nerve fibers and Langerhans cells in patients with and without HIV-SN.DESIGN, SETTING, AND PARTICIPANTS This prospective, cross-sectional cohort study was conducted between July 24, 2015, and September 17, 2015. Twenty patients who were HIV positive were recruited from adult outpatient clinics at Chelsea and Westminster Hospital NHS Foundation Trust in England. These patients underwent IVCCM at Moorfields Eye Hospital NHS Foundation Trust in London, England, and the IVCCM images were analyzed at Weill Cornell Medicine-Qatar in Ar-Rayyan, Qatar. Patients were given a structured clinical examination and completed validated symptom questionnaires and the Clinical HIV-Associated Neuropathy Tool. Results from patients with HIV were compared with the results of the age-and sex-matched healthy control participants (n = 20). All participants were classified into 3 groups: controls, patients with HIV but without SN, and patients with HIV-SN. MAIN OUTCOMES AND MEASURESComparison of corneal nerve fiber density, corneal nerve branch density, corneal nerve fiber length, corneal nerve fiber tortuosity, and corneal Langerhans cell density between healthy controls and patients with HIV with and without SN.RESULTS All 40 participants were male, and most (Ն70%) self-identified as white. Of the 20 patients with HIV, 14 (70%) had HIV-SN. This group was older (mean [SD] age, 57.7 [7.75] years) than the group without HIV-SN (mean [SD] age, 42.3 [7.26] years) and the controls (mean [SD] age, 53.8 [10.5] years). Corneal nerve fiber density was reduced in patients with HIV compared with the controls (26.7/mm 2 vs 38.6/mm 2 ; median difference, −10.37; 95.09% CI, −14.27 to −6.25; P < .001) and in patients with HIV-SN compared with those without (25.8/mm 2 vs 30.7/mm 2 ; median difference, −4.53; 95.92% CI, −8.85 to −0.26; P = .03). Corneal nerve branch density and corneal nerve fiber length were reduced in patients with HIV, but no differences were identified between those with neuropathy and without neuropathy (corneal nerve branch density: 95.83/mm 2 for the controls vs 72.37/mm 2 for patients with HIV; median difference, −24.53; 95.32% CI, −50.62 to −3.13; P = .01; and corneal nerve fiber length: 28.4 mm/mm 2 for the controls vs 21.9 mm/mm 2 for patients with HIV; median difference, −5.24; 95.09% CI, −8.83 to −1.38; P = .001). Tortuosity coefficient was increased in patients with HIV compared with controls (16.44 vs 13.95; median difference, 2.34; 95.09% CI, 0.31 to 4.65; P = .03) and in those with HIV-SN compared with those without (17.84 vs 14.18; median difference, 4.32; 95.92% CI, 0.68-9.23; P = .01). No differences were identified in corneal Langerhans cell density (19.84 cells/m...

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Use of Corneal Confocal Microscopy to Evaluate Small Nerve Fibers in Patients With Human Immunodeficiency Virus

et al. 2017

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“…One must be aware of the risk of compromising skin vitality when performing a rhytidectomy as a treatment modality. This is especially important in HIV patients receiving HAART since epidermal and subcutaneous fat thickness is already reduced [5,25]. This phenomenon was clearly noticeable during surgery by means of a fragile skin ap.…”

Section: Discussionmentioning

confidence: 99%

“…She presents with a pattern of deep fat accumulation mainly in the anterocervical area. In addition to the atrophy of subcutaneous fat with subsequent de ation and ptosis of midfacial soft tissues, this contributes to the appearance of an aged face [5,25]. As mentioned by several authors before, there is no proven bene t from switching to lipohypertrophy-sparing regimens to adequately reduce lipodystrophy stigmata, therefore warranting a surgical approach [2, 9, 13, 28].…”

Section: Discussionmentioning

confidence: 99%

The deep-plane facelift as a treatment modality for antiretroviral therapy induced cervicofacial lipodystrophy

Kustermans

Genechten

Casteele³

et al. 2022

Preprint

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PURPOSE Highly Active Anti Retroviral Therapy (HAART) has become an effective treatment modality to reduce HIV-infection to an undetectable viral load. These antiretroviral agents may, however, cause severe morbidity by inducing the syndrome of lipodystrophy. In the head and neck region antiretroviral agents generate an obtuse heavy neck in combination with an accelerated pattern of midfacial atrophy and ptosis. Modifying the antiretroviral therapy produces only limited improvement, therefore warranting a surgical approach. An extreme case of HAART-induced facial lipodystrophy is presented together with literature review to support the need for an extended surgical intervention in these patients. METHODS An overview of literature concerning the lipodystrophy effects of HAART and potential treatment modalities is carried out. This is illustrated with a case study of a 55-year old woman who received HAART therapy for 24 years and was particularly unhappy with her appearance due to cervical fat accumulation. Surgical technique and clinical results in this patient by means of deep-plane cervico-facial rhytidectomy including liposuction, subplatysmal lipectomy and platysma-digastric suspension are discussed. RESULTS The surgical technique has resulted in an aesthetically pleasing and predictable result with a quick recovery in this patient suffering from HAART-induced lipodystrophy. CONCLUSION The technique of deep-plane cervico-facial rhytidectomy including liposuction, subplatysmal lipectomy and platysma-digastric suspension is a valuable treatment modality in this patient group suffering from HAART-induced facial lipodystrophy. However, longitudinal studies of multiple subjects is required to assess stability of the outcome.

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“…Acredita-se que o retrovírus possa causar redução dos componentes intracelulares dos queratinócitos, levando à morte celular programada -apoptose (16,24) .…”

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[Id 43319] Alterações Na Epiderme De Pacientes Com Aids Autopsiados Em Uso Da Terapia Antirretroviral

Favarato

Silva

Oliveira

et al. 2020

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Objetivo: Avaliar a influência da terapia na morfologia da epiderme de pacientes com Síndrome da Imunodeficiência Adquirida - AIDS. Metodologia: Estudo transversal desenvolvido na Universidade Federal do Triângulo Mineiro, Brasil. Foram selecionados pacientes com AIDS de ambos os sexos, que foram agrupados de acordo com o tratamento com Terapia antirretroviral de alta eficiência: pacientes em uso de HAART (n = 14) e pacientes sem uso de HAART (n = 14). Outras informações foram coletadas do prontuário clínico. Resultados: A idade média dos pacientes em tratamento foi de 49,07 ± 7,89 anos e dos pacientes sem TARV foi de 55,11 ± 10,17 anos. A maioria dos pacientes na terapia utilizada pertencia ao sexo feminino, 9 (64,28%). Estes apresentaram espessamento epidérmico (150,04 x 86,09µm), número de camadas celulares (8,0 x 5,5 camadas) e densidade de células de Langerhans superiores àquelas que não utilizaram a terapia, com diferença significativa. Conclusão: Nossos achados sugerem que o HAART proporciona a recuperação dos constituintes da epiderme alterados pela doença, melhorando sua função como barreira chave na proteção do corpo contra microorganismos ambientais. DESCRITORES: Pele. Terapia Anti-retroviral Altamente Ativa. Envelhecimento. Epiderme. Morfologia.

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Morphological and immunological changes in the skin of autopsied women with AIDS

Cited by 5 publications

References 43 publications

Use of Corneal Confocal Microscopy to Evaluate Small Nerve Fibers in Patients With Human Immunodeficiency Virus

Use of Corneal Confocal Microscopy to Evaluate Small Nerve Fibers in Patients With Human Immunodeficiency Virus

The deep-plane facelift as a treatment modality for antiretroviral therapy induced cervicofacial lipodystrophy

[Id 43319] Alterações Na Epiderme De Pacientes Com Aids Autopsiados Em Uso Da Terapia Antirretroviral

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