The histological appearances of the adult Kidney in HIV infection at autopsy at the University Teaching Hospital in Lusaka

Introduction: Kidney disease in acquired immunodeficiency syndrome is very
common. The cause of the various histological appearances include HIV infection
of the kidney, immunologic responses to the virus, opportunistic infections,
neoplasms and consequences of anti-retroviral therapy that characterize the
acquired immunodeficiency virus (AIDS). There are no autopsy studies conducted
in HIV-infected cases in sub-Saharan Africa on the histological lesions of the
kidney.
Methods: A descriptive study of 200 paraffin blocked kidney autopsy tissue
samples collected between 2010 and 2012 in the Zambia Neuro-AIDS study
(Subtype C Neuro-AIDS and pathogenesis in Zambia) was conducted at the
University Teaching hospital in Lusaka, Zambia. The study aimed at describing the
histological appearances of the adult kidney in Human Immunodeficiency Virus
infection.
The study population consisted of all HIV infected cases above the age of 16years
that had been on anti-retroviral therapy and those that were not commenced. The
decedents were unselected for the presence of overt kidney disease. Paraffin
blocked kidney tissue samples were processed according to standard
histopathology laboratory protocols at the University Teaching Hospital and
examined at light microscopic level.
Results: Two hundred (200) cases were examined of which 128 cases were male
and 72 were female. One hundred and sixty nine cases (84.5%) revealed renal
lesions. The renal histopathological lesions included; tubulointerstitial 65%,
glomerular 59%, vascular 2%, and 19.5 % of cases revealed renal tuberculosis.
Fungal, viral infections and malignancies were not identified.
Conclusion: The investigation has shown that renal lesions are highly prevalent
(84.5%) among HIV infected cases at the University Teaching Hospital.