dc.contributor.author |
Danaviah, S.
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dc.contributor.author |
Govender, S.
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dc.contributor.author |
Cassol, Sharon
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dc.date.accessioned |
2007-11-06T07:02:41Z |
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dc.date.available |
2007-11-06T07:02:41Z |
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dc.date.issued |
2007-07 |
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dc.description.abstract |
Approximately 2 million South Africans are HIV/TB coinfected, and many develop skeletal disease. The resurgence of spinal tuberculosis, including atypical forms, is due largely to HIV-associated immune suppression. We investigated the impact of HIV coinfection on the histological features of the disease and the occurrence of atypical opportunistic organisms in infectious spondylitis in an HIV/TB endemic region. We analyzed blood and tissue biopsies from 60 patients with tuberculous spondylitis. Investigations included full blood counts, CD4/CD8 counts, HIV-1 serology and RNA quantification (tissue and plasma), acid-fast bacilli localization and routine TB culture, histopathologic evaluation of biopsies, and bacterial genotyping using the 16S rDNA gene. Twenty-two patients (37%) were HIV positive with a mean age of 29 years (range, 2-65 years). Forty-one (68%) tissue specimens were culture negative for Mycobacterium tuberculosis (Mtb), although nontuberculous mycobacteria (NTM) were identified in three HIV-negative patients. Histopathologic features were characteristic of TB infection in 91.4% of all specimens tested and 100% of the HIV-infected group. Genotyping of 10 culture-positive isolates identified Mtb (3/10), NTMs (2/10), and environmental bacilli (3/10). Our observations suggest HIV-induced immune suppression impacts the histological and clinical features of infectious spondylitis but has no impact on the incidence of NTMs in this setting. |
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dc.description.sponsorship |
The authors thank Prof. T. Naicker (HOD, Optics and Imaging Unit, UKZN), Mrs. R. Reddy (Laboratory Technologist, Dept. of
Pathology, NALCH), and Dr. A. Bramdev (Pathologist, Lancet Laboratories). |
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dc.format.extent |
12137 bytes |
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dc.format.mimetype |
application/pdf |
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dc.identifier.citation |
Danaviah, S, Govender, S & Cassol, S 2007, 'Histopathology and genotyping in infectious spondylitis of HIV- and HIV+ patients', Clinical Orthopaedics and Related Research, vol. 460, pp. 50-55. [http://www.corronline.com] |
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dc.identifier.issn |
0009-921X |
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dc.identifier.issn |
1528-1132 |
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dc.identifier.other |
10.1097/BLO.0b013e31806a9147 |
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dc.identifier.uri |
http://hdl.handle.net/2263/3859 |
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dc.language.iso |
en |
en |
dc.publisher |
Lippincott Williams and Wilkins |
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dc.rights |
Lippincott Williams and Wilkins. The publisher prohibits open access to the full text of this article |
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dc.subject |
HIV |
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dc.subject |
Tuberculosis |
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dc.subject.lcsh |
Spondylitis -- South Africa |
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dc.subject.lcsh |
Immunosuppression -- South Africa |
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dc.subject.lcsh |
Spine -- Abnormalities -- South Africa |
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dc.subject.lcsh |
HIV infections -- Complications -- South Africa |
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dc.subject.lcsh |
Tuberculosis -- Complications -- South Africa |
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dc.title |
Histopathology and genotyping in infectious spondylitis of HIV- and HIV+ patients |
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dc.type |
Text |
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