Hoda S A, White J E, Gerber M A
Department of Pathology, Tulane University School of Medicine, New Orleans, Louisiana.
Mod Pathol. 1991 Sep;4(5):578-81.
A wide spectrum of hepatic lesions has been reported in AIDS, but it is not known whether the changes are related to the presence of human immunodeficiency virus type 1 (HIV-1). Therefore, we examined liver sections from 15 consecutively autopsied patients with AIDS for the presence of HIV-1 antigens p24 (core) and gp41 (envelope) by the avidin-biotin-peroxidase complex method using monoclonal antibodies. The most common histologic abnormalities noted were steatosis, portal inflammation, Kupffer cell hyperplasia, and focal hepatocellular and bile duct damage. Intra-hepatic opportunistic organisms were detected in six of 15 (40%) cases, with Mycobacterium avium-intracellulare being the commonest (four cases). Immunoreactivity for HIV-1 antigens was demonstrated in 12 of 15 cases (80%), with staining limited to Kupffer cells and other mononuclear cells characterized by a lymphoid morphology. Approximately the same number and type of cells were stained with both monoclonal antibodies and did not bear any relation to the degree of histologic abnormalities nor to the presence of opportunistic infections. The data suggest that some pathologic changes in AIDS livers are more likely the result of an indirect effect mediated by infected resident and circulating mononuclear cells than a direct cytopathic effect of HIV-1.
艾滋病患者已被报道出现多种肝脏病变，但尚不清楚这些改变是否与1型人类免疫缺陷病毒（HIV-1）的存在有关。因此，我们使用单克隆抗体，通过抗生物素蛋白-生物素-过氧化物酶复合物法，检查了15例连续尸检的艾滋病患者肝脏切片中HIV-1抗原p24（核心）和gp41（包膜）的存在情况。观察到的最常见组织学异常为脂肪变性、门脉炎症、库普弗细胞增生以及局灶性肝细胞和胆管损伤。15例中有6例（40%）检测到肝内机会性病原体，其中鸟分枝杆菌复合体最为常见（4例）。15例中有12例（80%）显示出HIV-1抗原免疫反应性，染色仅限于库普弗细胞和其他具有淋巴细胞形态特征的单核细胞。两种单克隆抗体染色的细胞数量和类型大致相同，且与组织学异常程度或机会性感染的存在均无关联。数据表明，艾滋病患者肝脏的某些病理变化更可能是由受感染的驻留和循环单核细胞介导的间接效应所致，而非HIV-1的直接细胞病变效应。
