Abstract

PIP: AIDS is the leading cause of death among adults in at least two capital cities in Africa: Abidjan, Cote d'Ivoire, and Kinshasa, Zaire. Knowledge of the causes of morbidity and mortality in HIV-positive people in Africa is, however, less than complete due to limited postmortem diagnostic facilities, difficulties in obtaining consent for postmortem examinations, and a general lack of pathologists. Although HIV affects all organs, either directly or by facilitating opportunistic infections and tumors, pulmonary insufficiency, wasting, cerebral lesions compromising vital centers, and overwhelming toxic systemic infection are the major causes of HIV disease. Virtually every pathological lesion described in developed countries has also been seen in Africa. This paper discusses what is known of the major serious pathologies in sub-Saharan Africa. It is clear that more pathological diagnostic and follow-up data are needed before an accurate picture of the patterns and pathogeneses of the various manifestations of HIV infection in Africa can be drawn. Sections consider HIV-1 and HIV-2 infection, Mycobacterium tuberculosis infection, non-tuberculosis pulmonary disease, diarrhea and the wasting syndrome, neuropathology, specific systemic infections, tumors associated with HIV infection, and pediatric AIDS in Africa.