GEOGRAPHICAL PATHOLOGY PROFILE OF AIDS IN PUERTO-RICO - THE FIRST DECADE

Postmortem histopathological changes in 100 adult patients with AIDS w ho died in Puerto Rico from 1982 to 1991 were studied and tabulated. M odes of HIV transmission were reviewed. Patient ages ranged from 21 to 60 yr. Gender composition for the patient group was 83 men (average a ge, 35 yr) and 17 women (average age, 39 yr). Sixty-eight of the patie nts were injecting-drug users, 20 were homosexual and bisexual men, se ven were women who had had heterosexual contact with men at risk for H IV, and one was a man who had had heterosexual contact with prostitute s. Only one case was linked to transfusions of blood. Twenty-seven men and seven women were serologically tested for antibodies and all were HIV seroreactive. The most common causes of infection and the frequen cy of each were as follows: Pneumocystis carinii in 49 patients; cytom egalovirus in 43; Toxoplasma gondii in 30; Candida species in 24; Hist oplasma capsulatum in 18; Mycobacterium species in 14; Cryptococcus sp ecies in eight; and Strongyloides stercoralis in six patients. Infecti on by Schistosoma mansoni (10 patients) was considered incidental beca use this trematode is endemic in Puerto Rico. The lung was the organ m ost frequently infected by a single microorganism: Pneumocystis carini i affected 49 patients. However, Cryptococcus species was the microorg anism that infected more body systems: 20 different organs in eight pa tients. Nineteen patients had microglial nodular encephalitis, 86 pati ents had lymphocyte depletion in the spleen, and 58 had lymphocyte dep letion in lymph node tissue. Twenty-seven men had testicular maturatio n arrest and variable germ cell loss. Three patients had malignant lym phoma, and two had Kaposi's sarcoma. This geographical pathology profi le defines the first phase of the AIDS pandemic on the island of Puert o Rico.