The Usefulness of HIV-1p24 in Detecting the Presence of HIV Infection in Histopathology Tissue Specimens

Abstract

Introduction HIV (human immunodeficiency virus)-associated immunodeficiency is the single most important acquired immunodeficiency in humans, underlying several diseases. The presence of HIV infection may be unsuspected or undetected in tissues due to latency or failure of the consulting physician to document it on the requisition form. HIV-1p24 protein is a component of the HIV particle capsid that can be exploited serologically and immunohistochemically to detect the presence of HIV infection. This study aimed to assess the usefulness of HIV-1 p24 immunohistochemistry in detecting the presence of HIV infection in histopathology tissues in a resource-challenged setting. Materials and Methods HIV-1p24 immunohistochemical expression was evaluated in 59 cases from the archives of both Nnamdi Azikiwe University Teaching Hospital (NAUTH) and Pathocon Specialist Clinic and Research Institute over a 10-year period. Pathology consult forms of all clinically and morphologically suspected cases of Kaposi sarcoma and their blocks were retrieved, recut, and reviewed using hematoxylin and eosin, and then subjected to HIV-1p24 immunohistochemical staining. Results Of the 59 cases, 38 expressed p24, whereas 21 were negative. Fifteen of the positive cases had no prior documented evidence of HIV infection. Five cases with clinically known statuses, four positive and one negative, were found to be negative and positive, respectively, following HIV-1p24 immunohistochemical staining, probably due to usage of ELISA (enzyme-linked immunosorbent assay) detection kit only and long term antiretroviral therapy. HIV infection was commoner in the third and fourth decades of life. Conclusion HIV-1p24 is a useful low-cost immunohistochemical marker in detecting the presence of HIV infection in histopathology specimens, even in previously unsuspected cases.