Department of Histopathology, St Thomas' Hospital, London, UK.
J Pathol. 2015 Jan;235(2):229-41. doi: 10.1002/path.4449.
Infection with the human immunodeficiency virus (HIV) causes systemic T cell destruction and reduced cell-mediated immunity that leads to a wide range of opportunistic infections and cancers. Second, it directly damages many tissues - gut, brain, lung - through mononuclear cell infection and activation. Third, through immune activation and effects on endothelia, it can cause more subtle systemic organ damage, such as chronic cardiovascular, hepatic, pulmonary and central nervous system disease. Antiretroviral treatment has enabled HIV-infected persons to live with chronic infection, although with some side-effects and mortality, including reactions due to the immune reconstitution inflammatory syndrome (IRIS). As cohorts of infected people get older, age-related diseases will combine with chronic HIV infection to produce disabilities whose scale is not yet understood. HIV is detectable in tissues by immunohistochemistry when infection loads are high, such as at first presentation. Pathologists should proactively consider HIV disease in routine diagnostic work, so as to identify more HIV-infected patients and enable their optimal management.
感染人类免疫缺陷病毒 (HIV) 会导致全身 T 细胞破坏和细胞介导免疫功能降低，从而导致广泛的机会性感染和癌症。其次，它通过单核细胞感染和激活直接损害许多组织 - 肠道、大脑、肺部。第三，通过免疫激活和对内皮细胞的影响，它还会引起更微妙的全身器官损伤，如慢性心血管、肝脏、肺部和中枢神经系统疾病。抗逆转录病毒治疗使 HIV 感染者能够长期感染，但也有一些副作用和死亡率，包括免疫重建炎症综合征 (IRIS) 引起的反应。随着感染人群年龄的增长，与年龄相关的疾病将与慢性 HIV 感染相结合，产生的残疾程度尚不清楚。当感染负荷较高时，例如初次就诊时，免疫组织化学可检测到组织中的 HIV。病理学家应在常规诊断工作中主动考虑 HIV 疾病，以便发现更多的 HIV 感染患者并对其进行最佳管理。
