Bridging the Gap: Conference Record [Abstract book, International Conference on AIDS (12th: 1998: Geneva, Switzerland)]

1184 Abstracts 61005-61004

12th World AIDS Conference

patients. 2. The high prevalence of Hep B may be associated with acquisition of
HIV infection from a bisexual or IVDU partner. 3. The high prevalence of cervical dysplasia highlights the need of targeted gynecologic care for HTV-infected
women.
Supported by Fogarty JHU International Training Grant.
61005 Autopsy findings in women with AIDS
Ruth Khalili. Rua Alzira Cortes 05/308, Botafogo, Rio de Janeiro
CEP-22260-050, Brazil
Objective: The describe the HIV-infected women causes of deaths and missed
diagnosis.
Methods: A chart review to collect epidemiological, clinical, immunological
and necropsy data considering all HIV-infected women deaths occurred in a
HIV-infected women cohort followed at Evadro Chagas Hospital/Fiocruz (HEC)
from 1/1988 to 12/1997.
Results: As of 12/97, 276 HIV-infected women have been included in the
cohort; 26 were lost for follow-up and 56 were dead. All these deaths occurred at

HEC and necropsy was obtained in 22 (39.2%). Mean age at AIDS diagnosis was
37.7 years (SD 10.7), mean survival time after AIDS diagnosis was 13 months.
Most of these women were sexually infected - 64.7%, 3.8% through blood transfusion, 1.9% were IVDU, and in 27.7% the exposure mode was not identified. The
most frequent AIDS-related illnesses were: oral candidiasis (86.7%), tuberculosis
(67.5%), PCP (55.5%), esophageal candidiasis (32.2%), CMV disease (30.2%),
recurrent vaginal candidiasis (28%), sinusitis (22.6%), recurrent bacterial
pneumonia (20.8%), CNS toxoplasmosis (18.8%), isosporiasis (19%). The most
frequent causes of death were septicemia 20 (35.7%), multiple organs failure 6
(10.7%), intracranial hypertension 7 (12.5%) and aspirative pneumonia 4 (7%).
The mean CD4 count closest to death was 82.8 cells/mm3 (SD 82.5). The following diagnosis were only made by post mortum examination (autopsy): CMV (6),
candida esophagitis (2), bronchopneumonia (3), PCP 92), disseminated Kaposi's
sarcoma (1), metastatic lymphoid neoplasia (1), non-Hodgkin's lymphoma (1).
Conclusions: 1. Bacterial infections are the most frequent cause of death in
our cohort. 2. The fact that Tb diagnosis was not missed during life points out the
high index of suspicion of this disease at HEC. 3. As the survival is increasing
among HIV+ patients, the frequency of neoplastic disease is expected to increase.
Suppordted by Fogarty JHU International Training Grant.