[Cardiac involvement in carriers of the human immunodeficiency virus. Report of 38 cases]

Abstract

The anatomopathological study of the heart, carried out during the autopsy of a series of 38 subjects seropositive for the human immunodeficiency virus, has enabled the observation of histological lesions in 23 cases (60%). The heart affection is more often asymptomatic since it has been clinically suspected in only four cases. A myocarditis is present in 42 p. cent of the cases, and lesions specific to a pathogenic agent are visible in half of the myocarditis cases. These pathogenic agents are: toxoplasma (2 cases), cryptococcus (2 cases), candida (1 case), aspergillus (1 case) and cytomegalovirus (1 case). Lymphocytic myocarditis, with no isolated aetiological agent, and without viral inclusion, has been observed in 9 cases. The histological affection of the pericardium is observed in 4 cases and that of the endocardium in 3 cases. The lesions are not specific. The cardiotropism of the HIV is suspected, but not established. It could explain the frequency of lymphocytic myocarditis and dilated cardiomyopathies observed in HIV positive patients. The frequency of heart localizations in HIV positive subjects, even strictly asymptomatic as observed in this study, leads us to advise a systematic specialized cardiac examination.