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

dc.contributor.authorDanaviah, S.
dc.contributor.authorGovender, S.
dc.contributor.authorCassol, Sharon
dc.date.accessioned2007-11-06T07:02:41Z
dc.date.available2007-11-06T07:02:41Z
dc.date.issued2007-07
dc.description.abstractApproximately 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.sponsorshipThe 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.extent12137 bytes
dc.format.mimetypeapplication/pdf
dc.identifier.citationDanaviah, 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.issn0009-921X
dc.identifier.issn1528-1132
dc.identifier.other10.1097/BLO.0b013e31806a9147
dc.identifier.urihttp://hdl.handle.net/2263/3859
dc.language.isoenen
dc.publisherLippincott Williams and Wilkinsen
dc.rightsLippincott Williams and Wilkins. The publisher prohibits open access to the full text of this articleen
dc.subjectHIVen
dc.subjectTuberculosisen
dc.subject.lcshSpondylitis -- South Africa
dc.subject.lcshImmunosuppression -- South Africa
dc.subject.lcshSpine -- Abnormalities -- South Africa
dc.subject.lcshHIV infections -- Complications -- South Africa
dc.subject.lcshTuberculosis -- Complications -- South Africa
dc.titleHistopathology and genotyping in infectious spondylitis of HIV- and HIV+ patientsen
dc.typeTexten

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