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HIV-associated Infective Native Aortic Aneurysms

Jönsson, Adam ; Ljungquist, Oskar LU and Sörelius, Karl (2023) In APMIS : acta pathologica, microbiologica, et immunologica Scandinavica 131(1). p.3-12
Abstract
Background
HIV-associated infective native aortic aneurysms (INAA) constitute a subcategory of the disease INAA. This is a very rare group of patients.

Objectives
The aim of this systematic literature review was to compile a description of patient characteristics with HIV-associated INAA.

Methods
A systematic literature review was performed using the search terms HIV and aortic aneurysm in Ovid MEDLINE and Embase databases, on articles published between 1981-2022. Using the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement, articles were scrutinised according to a predefined protocol including age, sex, co-morbidities, microbiological pathogens, CD4-count, HIV/AIDS state,... (More)
Background
HIV-associated infective native aortic aneurysms (INAA) constitute a subcategory of the disease INAA. This is a very rare group of patients.

Objectives
The aim of this systematic literature review was to compile a description of patient characteristics with HIV-associated INAA.

Methods
A systematic literature review was performed using the search terms HIV and aortic aneurysm in Ovid MEDLINE and Embase databases, on articles published between 1981-2022. Using the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement, articles were scrutinised according to a predefined protocol including age, sex, co-morbidities, microbiological pathogens, CD4-count, HIV/AIDS state, aortic segment involved, treatment and outcome.

Results
Thirty-three studies, all case reports with a total of 39 patients, were included. The median age was 48 years (range 27-79), most were male n=35 (90%), and the median follow-up was n=6 months (range 0-63). Cardiovascular comorbidity was present in n=1 (3%), median CD4-count was 216 (range 6-1236), and n=12 (31%) had AIDS. The most common microbiological pathogens were Treponema pallidum, n=12 (31%), Salmonella spp. n=10 (26%), Mycobacterium species n=5 (12%), and Staphylococcal spp. n=5 (13%). The HIV-associated INAAs were localized in the abdominal aorta n=32 (82%), in the thoracic aorta n=5 (13%) and in the thoraco-abdominal aorta n=2 (5%). Open surgery was performed in n=23 (59%) patients, endovascular aortic repair n=6 (15%), and n=7 (18%) did not receive surgery. Infection-related complications were reported in n=2 (7%) patients, both with postoperative development of fatal sepsis.

Conclusion
Patients with HIV-associated INAAs, were younger, had lower rate of cardiovascular comorbidity, demonstrated low CD4-counts as a measure of immunosuppression, and demonstrated diverse microbiological pathogens compared with other INAAs. Treponema Pallidum and Mycobacterium spp. were common pathogens, which are very rare microbiological pathogens in other INAAs. (Less)
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author
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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
APMIS : acta pathologica, microbiologica, et immunologica Scandinavica
volume
131
issue
1
pages
3 - 12
publisher
John Wiley & Sons Inc.
external identifiers
  • scopus:85139083902
  • pmid:36106509
ISSN
0903-4641
DOI
10.1111/apm.13273
language
English
LU publication?
yes
id
445f2231-287f-4d04-9f07-696af88a1ad0
date added to LUP
2022-09-15 20:31:19
date last changed
2023-01-16 10:17:57
@article{445f2231-287f-4d04-9f07-696af88a1ad0,
  abstract     = {{Background<br/>HIV-associated infective native aortic aneurysms (INAA) constitute a subcategory of the disease INAA. This is a very rare group of patients.<br/><br/>Objectives<br/>The aim of this systematic literature review was to compile a description of patient characteristics with HIV-associated INAA.<br/><br/>Methods<br/>A systematic literature review was performed using the search terms HIV and aortic aneurysm in Ovid MEDLINE and Embase databases, on articles published between 1981-2022. Using the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement, articles were scrutinised according to a predefined protocol including age, sex, co-morbidities, microbiological pathogens, CD4-count, HIV/AIDS state, aortic segment involved, treatment and outcome.<br/><br/>Results<br/>Thirty-three studies, all case reports with a total of 39 patients, were included. The median age was 48 years (range 27-79), most were male n=35 (90%), and the median follow-up was n=6 months (range 0-63). Cardiovascular comorbidity was present in n=1 (3%), median CD4-count was 216 (range 6-1236), and n=12 (31%) had AIDS. The most common microbiological pathogens were Treponema pallidum, n=12 (31%), Salmonella spp. n=10 (26%), Mycobacterium species n=5 (12%), and Staphylococcal spp. n=5 (13%). The HIV-associated INAAs were localized in the abdominal aorta n=32 (82%), in the thoracic aorta n=5 (13%) and in the thoraco-abdominal aorta n=2 (5%). Open surgery was performed in n=23 (59%) patients, endovascular aortic repair n=6 (15%), and n=7 (18%) did not receive surgery. Infection-related complications were reported in n=2 (7%) patients, both with postoperative development of fatal sepsis.<br/><br/>Conclusion<br/>Patients with HIV-associated INAAs, were younger, had lower rate of cardiovascular comorbidity, demonstrated low CD4-counts as a measure of immunosuppression, and demonstrated diverse microbiological pathogens compared with other INAAs. Treponema Pallidum and Mycobacterium spp. were common pathogens, which are very rare microbiological pathogens in other INAAs.}},
  author       = {{Jönsson, Adam and Ljungquist, Oskar and Sörelius, Karl}},
  issn         = {{0903-4641}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{3--12}},
  publisher    = {{John Wiley & Sons Inc.}},
  series       = {{APMIS : acta pathologica, microbiologica, et immunologica Scandinavica}},
  title        = {{HIV-associated Infective Native Aortic Aneurysms}},
  url          = {{http://dx.doi.org/10.1111/apm.13273}},
  doi          = {{10.1111/apm.13273}},
  volume       = {{131}},
  year         = {{2023}},
}