ULTRASTRUCTURAL FINDINGS IN THE COCHLEA OF AIDS CASES

Neurotologic manifestations associated with the human immunodeficiency virus (HIV-1) are poorly understood. Eight temporal bones of acquired immunodeficiency syndrome (AIDS) cases were dissected and investigate d ultrastructurally to determine if pathogens and pathologic changes w ere present within the cochlea. Extracellular viral-like particles wit h morphologic characteristics of HIV-1 were identified on the tectoria l membrane in three cases. Numerous viral-like particles with cores ap peared trapped within lacunae along the tectorial membrane in one spec imen. Intracellular viral-like particles, appearing essentially simila r to identified HIV-1 particles of infected lymphocyte cultures, were found within the cytoplasm of connective tissue cells. These same cell s had gradients of enlarged viral envelopes forming cisterns that cont ained cores and varying amounts of cistern particulate. Some sectioned profiles of enlarged cytoplasmic cisterns revealed the attachment and inward protrusion of the core from the cistern wall. Other ultrastruc tural findings included cytoplasmic globular-dense particulate bodies, aggregates of smaller viral-like particles, and mitochondrial changes . This demonstration of prominent viral-like particles and cochlear pa thology may help to explain the neurotologic manifestations associated with HIV-1 infection.