Histopathology and genotyping in infectious spondylitis of HIV- and HIV+ patients

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dc.contributor.author Danaviah, S.
dc.contributor.author Govender, S.
dc.contributor.author Cassol, Sharon
dc.date.accessioned 2007-11-06T07:02:41Z
dc.date.available 2007-11-06T07:02:41Z
dc.date.issued 2007-07
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. en
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). en
dc.format.extent 12137 bytes
dc.format.mimetype application/pdf
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] en
dc.identifier.issn 0009-921X
dc.identifier.issn 1528-1132
dc.identifier.other 10.1097/BLO.0b013e31806a9147
dc.identifier.uri http://hdl.handle.net/2263/3859
dc.language.iso en en
dc.publisher Lippincott Williams and Wilkins en
dc.rights Lippincott Williams and Wilkins. The publisher prohibits open access to the full text of this article en
dc.subject HIV en
dc.subject Tuberculosis en
dc.subject.lcsh Spondylitis -- South Africa
dc.subject.lcsh Immunosuppression -- South Africa
dc.subject.lcsh Spine -- Abnormalities -- South Africa
dc.subject.lcsh HIV infections -- Complications -- South Africa
dc.subject.lcsh Tuberculosis -- Complications -- South Africa
dc.title Histopathology and genotyping in infectious spondylitis of HIV- and HIV+ patients en
dc.type Text en


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