Autopsy findings in the acquired immunodeficiency syndrome (AIDS). A report of 395 cases from the South of France

Necropsy findings in 395 adult patients with the acquired immunodeficiency syndrome (AIDS) who died in Nice, France, between March 1983 and May 1996 w ere compared retrospectively with antemortem diagnoses, risk factors and nu mber of positive T CD4 lymphocytes at the time of death. Special emphasis o n bacterial infections was made in this study. Lesions observed from 1983 t hrough 1989 and from 1990 through 1996 were compared. We assessed the role of organ lesions in the immediate cause of death. The organ system distribu tion of major opportunistic infections and neoplasms was similar throughout the years of the study. The most common diagnostic disease entities in all organ sites were cytomegalovirus infection, toxoplasmosis and candidiasis. Toxoplasmosis was more common in the intravenous drug abuser group. Bacter ial infections were frequent and contributed to the mortality and morbidity of all risk factor groups. Kaposi' sarcoma continued to occur more frequen tly in the homosexual population. Cytomegalovirus infection remained one of the most common causes of death from 1983 to 1996. Mortality from fungal a nd bacterial infections, and mycobacteriosis increased in frequency during the course of this study whereas deaths from pneumocystosis declined. The d eath rate from malignant lymphoma and carcinoma increased after 1989. The c linical cause of death concurred with the pathological cause in 55% of the cases. Lung was the most frequent organ involved followed by the central ne rvous system, the gastrointestinal tract and the heart.