Arterial aneurysms in patients infected with human immunodeficiency virus:A distinct clinicopathology entity?

Arterial aneurysms have only recently been associated with the human immuno deficiency virus (HIV). The clinical and pathological features of 10 HIV-po sitive patients with arterial aneurysms were retrospectively evaluated. The se aneurysms were unusual in that they affected young black patients, occur red in atypical sites, and tended toward multiplicity Surgery was performed in eight-patients. Acute and chronic inflammatory changes were revealed by means of histologic examination of the aneurysm walls, with occlusion of t he vasa vasora by inflammatory infiltrate or edema being a prominent featur e. Culture of the aneurysm wall or thrombus yielded positive results in two patients; The association between HIV and aneurysms may be coincidental, c aused by direct viral action or by bacterial infection resulting from immun osuppression. Implications for therapy are discussed, and the need for furt her study is highlighted.