Osteonecrosis of the femoral head in people living with HIV: anatomopathological description and p24 antigen test

Ana Lucia L Munhoz Lima,1 Priscila Rosalba Oliveira,1 Vladimir C Carvalho,1 Alexandre Leme Godoy-Santos,1 Leandro Ejnisman,1 Claudia R Oliveira,1 David E Uip,2 Maria Irma S Duarte3 1Instituto de Ortopedia e Traumatologia, Hospital das Clínicas HCFMUSP, Universidade de São Paulo...

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Autores principales: Munhoz Lima ALL, Oliveira PR, Carvalho VC, Godoy-Santos AL, Ejnisman L, Oliveira CR, Uip DE, Duarte MIS
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Publicado: Dove Medical Press 2018
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spelling oai:doaj.org-article:38c66d0237794e0ea01177b65d74bf462021-12-02T01:54:44ZOsteonecrosis of the femoral head in people living with HIV: anatomopathological description and p24 antigen test1179-1373https://doaj.org/article/38c66d0237794e0ea01177b65d74bf462018-05-01T00:00:00Zhttps://www.dovepress.com/osteonecrosis-of-the-femoral-head-in-people-living-with-hiv-anatomopat-peer-reviewed-article-HIVhttps://doaj.org/toc/1179-1373Ana Lucia L Munhoz Lima,1 Priscila Rosalba Oliveira,1 Vladimir C Carvalho,1 Alexandre Leme Godoy-Santos,1 Leandro Ejnisman,1 Claudia R Oliveira,1 David E Uip,2 Maria Irma S Duarte3 1Instituto de Ortopedia e Traumatologia, Hospital das Clínicas HCFMUSP, Universidade de São Paulo, São Paulo, Brazil; 2Faculdade de Medicina da Fundacao do ABC, São Paulo, Brazil; 3Departamento de Patologia, Faculdade de Medicina FMUSP, Universidade de São Paulo, Sao Paulo, Brazil Objective: To examine the presence of HIV in bone tissue of people living with HIV (PLWHIV) with osteonecrosis of femoral head and describe clinical and anatomopathological findings.Design: This is a case series which included 44 PLWHIV with osteonecrosis of femoral head who underwent total hip arthroplasty.Methods: Clinical data were obtained through analysis of the patients’ medical records. Bone tissue obtained during total hip arthroplasty was retrieved and sent for conventional and immunohistochemical analysis. Monoclonal antibodies were used to mark the p24 (HIV), CD31 (vascular endothelial cells), CD68 (macrophages), and D240 (cells of the lymphatic endothelium) antigens.Results: Dyslipidemia was found in 48% of the patients and lipodystrophy in 31%. Histological analysis showed similar characteristics for the entire sample. Degeneration of joint cartilage was visualized with the presence of fissures and fibrillations, as well as subchondral sclerosis and necrosis of the subchondral cancellous bone tissue. Lymphoplasmocytic inflammatory reaction was observed, with the presence of macrophages containing a foamy, vacuolated cytoplasm, as well as the presence of ceroid pigment and occasional granulation tissue. The reaction with the monoclonal anti-p24 antibody was negative in the samples from all 44 PLWHIV undergoing hip arthroplasty. Reactions with the anti-CD31 and anti-D240 antibodies were negative. Staining with CD68 antibody confirmed that the cells visualized with foamy, vacuolated cytoplasm were macrophages.Conclusion: p24 HIV antigen was not detected in the bone tissue of PLWHIV and osteonecrosis. The most frequent anatomopathological findings were extensive necrosis of bone tissue, large vacuoles filled with fat cells, inflammatory lymphoplasmocytic reaction with macrophages containing vacuolated cytoplasm, and the presence of ceroid pigment. Keywords: osteonecrosis, AIDS, HIV core protein p24, immunohistochemistryMunhoz Lima ALLOliveira PRCarvalho VCGodoy-Santos ALEjnisman LOliveira CRUip DEDuarte MISDove Medical PressarticleOsteonecrosisAcquired Immunodeficiency SyndromeHIV Core Protein p24ImmunohistochemistryImmunologic diseases. AllergyRC581-607ENHIV/AIDS: Research and Palliative Care, Vol Volume 10, Pp 83-90 (2018)
institution DOAJ
collection DOAJ
language EN
topic Osteonecrosis
Acquired Immunodeficiency Syndrome
HIV Core Protein p24
Immunohistochemistry
Immunologic diseases. Allergy
RC581-607
spellingShingle Osteonecrosis
Acquired Immunodeficiency Syndrome
HIV Core Protein p24
Immunohistochemistry
Immunologic diseases. Allergy
RC581-607
Munhoz Lima ALL
Oliveira PR
Carvalho VC
Godoy-Santos AL
Ejnisman L
Oliveira CR
Uip DE
Duarte MIS
Osteonecrosis of the femoral head in people living with HIV: anatomopathological description and p24 antigen test
description Ana Lucia L Munhoz Lima,1 Priscila Rosalba Oliveira,1 Vladimir C Carvalho,1 Alexandre Leme Godoy-Santos,1 Leandro Ejnisman,1 Claudia R Oliveira,1 David E Uip,2 Maria Irma S Duarte3 1Instituto de Ortopedia e Traumatologia, Hospital das Clínicas HCFMUSP, Universidade de São Paulo, São Paulo, Brazil; 2Faculdade de Medicina da Fundacao do ABC, São Paulo, Brazil; 3Departamento de Patologia, Faculdade de Medicina FMUSP, Universidade de São Paulo, Sao Paulo, Brazil Objective: To examine the presence of HIV in bone tissue of people living with HIV (PLWHIV) with osteonecrosis of femoral head and describe clinical and anatomopathological findings.Design: This is a case series which included 44 PLWHIV with osteonecrosis of femoral head who underwent total hip arthroplasty.Methods: Clinical data were obtained through analysis of the patients’ medical records. Bone tissue obtained during total hip arthroplasty was retrieved and sent for conventional and immunohistochemical analysis. Monoclonal antibodies were used to mark the p24 (HIV), CD31 (vascular endothelial cells), CD68 (macrophages), and D240 (cells of the lymphatic endothelium) antigens.Results: Dyslipidemia was found in 48% of the patients and lipodystrophy in 31%. Histological analysis showed similar characteristics for the entire sample. Degeneration of joint cartilage was visualized with the presence of fissures and fibrillations, as well as subchondral sclerosis and necrosis of the subchondral cancellous bone tissue. Lymphoplasmocytic inflammatory reaction was observed, with the presence of macrophages containing a foamy, vacuolated cytoplasm, as well as the presence of ceroid pigment and occasional granulation tissue. The reaction with the monoclonal anti-p24 antibody was negative in the samples from all 44 PLWHIV undergoing hip arthroplasty. Reactions with the anti-CD31 and anti-D240 antibodies were negative. Staining with CD68 antibody confirmed that the cells visualized with foamy, vacuolated cytoplasm were macrophages.Conclusion: p24 HIV antigen was not detected in the bone tissue of PLWHIV and osteonecrosis. The most frequent anatomopathological findings were extensive necrosis of bone tissue, large vacuoles filled with fat cells, inflammatory lymphoplasmocytic reaction with macrophages containing vacuolated cytoplasm, and the presence of ceroid pigment. Keywords: osteonecrosis, AIDS, HIV core protein p24, immunohistochemistry
format article
author Munhoz Lima ALL
Oliveira PR
Carvalho VC
Godoy-Santos AL
Ejnisman L
Oliveira CR
Uip DE
Duarte MIS
author_facet Munhoz Lima ALL
Oliveira PR
Carvalho VC
Godoy-Santos AL
Ejnisman L
Oliveira CR
Uip DE
Duarte MIS
author_sort Munhoz Lima ALL
title Osteonecrosis of the femoral head in people living with HIV: anatomopathological description and p24 antigen test
title_short Osteonecrosis of the femoral head in people living with HIV: anatomopathological description and p24 antigen test
title_full Osteonecrosis of the femoral head in people living with HIV: anatomopathological description and p24 antigen test
title_fullStr Osteonecrosis of the femoral head in people living with HIV: anatomopathological description and p24 antigen test
title_full_unstemmed Osteonecrosis of the femoral head in people living with HIV: anatomopathological description and p24 antigen test
title_sort osteonecrosis of the femoral head in people living with hiv: anatomopathological description and p24 antigen test
publisher Dove Medical Press
publishDate 2018
url https://doaj.org/article/38c66d0237794e0ea01177b65d74bf46
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