Coronary artery lesions and human immunodeficiency virus infectionLésions des artères coronaires et infection par le virus de l'immunodéficience humaine

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Summary

The postmortem anatomopathological examination of eight heart-and-lung specimens obtained from eight HIV-seropositive patients was performed. Three patients were CDC stage II and five patients were CDC stage IV. The mean age was 27 (range: 23–32). Distal and proximal vascular lesions of the coronary arteries were observed. These impairments were marked by major excentric atherosclerosis (with 80–90 % obstruction of the arterial lumen) or by fibrosis two-fold or six-fold the thickness of the tunica media. Sclero-hyalinosis of the smaller arteries and myocardial interstitial fibrosis lesions was also revealed.

In view of the severity of the described lesions, the absence of any associated cardiovascular risk factors and the context of immunodepression, the role of a virus in the genesis of these lesions is suggested, in particular a virus of the herpes group.

L'examen anatomopathologique de 8 blocs cœurpoumon de patients séropositifs et décédés a révélé des lésions vasculaires distales et proximales touchant les artères coronaires chez 3 sujets classés stade II et 5 classés stade IV (CDC), la moyenne d'âge étant de 27 ans (de 23 à 32 ans). Ces lésions sont représentées par une athérosclérose majeure (80–90 % de réduction de la lumière), excentrique, ou par une fibrose comprise entre 2 et 6 fois l'épaisseur de la média. Un épaississement scléro-hyalin des petites artères et des lésions myocardiques de fibrose interstitielle ont également été notés.

Etant donné l'importance des lésions décrites, l'absence de facteur de risque cardiovasculaire associés et le contexte d'immunodépression, le rôle d'un virus (du groupe herpès notamment) est évoqué dans la genèse de ces lésions.

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