Liver damage of autopsied patients with acquired immunodeficiency syndrome and antirretroviral therapy effect

Abstract

Aim: To evaluate steatosis percentage and hepatic interstitial fibers of autopsied patients with Acquired Immunodeficiency Syndrome (AIDS), relating to the use of antiretroviral therapy (ART). Methods: 62 liver fragments from patients with and without AIDS autopsied from 1996 to 2017, matched by age (18-49), gender and race. These patients were divided in two groups: patients with AIDS (n=31) and patients without AIDS (n=31). Patients with AIDS were analyzed according to treatment on ART (n=15) or non-ART (n=16). In the histomorphometric analysis sections were made and stained with hematoxylin-eosin, picrosirius and reticulin for steatosis, type I and type III collagen analysis, respectively. Results: Patients with AIDS showed significantly larger steatosis percentage (26.05 vs 21.95%, p<0.001), type I collagen (1.63 vs 1.01%, p<0.001) and type III collagen (8.68 vs 7.83%, p<0.001). Patients with AIDS on ART showed significantly lower steatosis percentage (25.45 vs 26.36%, p<0.001) and type I collagen (1.52 vs 1.75%, p<0.001). Patients with AIDS on ART showed lower percentage of type III collagen (8.52 vs 8.77%, p<0.96), however it was not statistically significant. Conclusion: AIDS increases in hepatocyte fat accumulation and steatosis and liver fibrosis. However, ART has a decreased beneficial role in hepatocyte fat accumulation and fibrosis development since the medication detains both processes.