MORPHOLOGY OF TUBERCULOSIS CONCURRENT WITH HIV INFECTION: POSTMORTEM DATA

Abstract

The pathomorphology of tuberculosis was studied in 129 deceased patients with concomitant HIV infection and in 50 patients with acutely progressive forms of the disease (a comparison group). In tuberculosis concurrent with HIV infection, the morphological pattern in the lung and other viscera depends on the primacy of a lesion and reflects the progressive pattern of specific inflammation. In the TB-HIV group, the signs of a pre-existing specific process with foci of fibrosis and hyalinosis, a mild or moderate granulomatous reaction with epithelioid cells always persist in the lung. The tuberculous process progresses due to lymphohematogenic and bronchogenic dissemination. The HIV-TB group is characterized by the preponderance of exudative and alterative changes, the absence of signs of separation and organization of inflammatory pyonecrotic foci having no signs of specificity in the lung and other viscera. Progression of tuberculous inflammation occurs mainly by hematogenic dissemination. In all the observed groups, there is lymphadenopathy that appears as caseuos necrosis in the TB-HIV group and reactive hyperplasia in the HIV-TB group.