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HIV and Pancreas: Endocrinological Patterns of Pancreatic Morphology

Context Acquired immunodeficiency syndrome has become a pandemic disease since the very first cases were reported in 1981.Many studies estimate a prevalence of metabolic syndrome in human immunodeficiency virus patients to 2-18%. The aim of this study is to evaluate the morphological aspect of the endocrine pancreas in acquired immunodeficiency syndrome patients with and without the use of highly active antiretroviral therapy. Methods It is a cross-sectional study carried out in 27 patients diagnosed with acquired immunodeficiency syndrome over the period of Jun 2006-Dec2009. They underwent highly active antiretroviral therapy treatment and necropsies were performed. Patients were divided into 2 groups: those who underwent highly active antiretroviral therapy were included in group 1, and those who did not in group 2.Morphological patterns of Langerhans islets were compared between groups. A total of 2 quantitative analyses were conducted: the counting of number of islets and their area calculation expressed in μ2.Each field was evaluated separately and all the data properly registered. Results The general analysis of the mean islet areas showed a significant difference (P=0.015). They were prone to hypertrophy in the highly active antiretroviral therapy group and presented no alterations in the control group. Discussion In the current study it was shown that the pancreas undergoes changes when infected with human immunodeficiency virus. The reported histological alterations in the current study strengthen the hypothesis that the endocrine section of the pancreas is strongly affected by the combined antiretroviral therapy, and it most likely powerfully influences the onset of glycemic alterations in this population. In conclusion, the postmortem pancreatic examination in this cohort of acquired immunodeficiency syndrome patients who underwent highly active antiretroviral therapy highlighted hypertrophy of the islets of Langerhans.

Author(s): Fernanda Molina Ferreira, Lara Guercio Dos Santos, Paulo Guilherme De Arruda Miranda, Rafaela Issa Afonso, Lucas Menezes Marques, Marcelo Bacci, Ana Maria Amaral Mader, Alexandre Gutierrez Barbosa, Ethel Zimberg Chether

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