Clinical profile of HIV-related aneurysms

Objectives: to describe the clinical features, management, outcome and labo ratory features of human immunodeficiency virus (HIV)-related aneurysms. Materials: twenty-eight HIV positive patients with arterial aneurysms treat ed at a single university teaching hospital in a 6-year period. Methods: case review of clinical records and laboratory findings. Specimens from patients surgically treated submitted for microbiological and histolo gical examination. Results: ninety-two aneurysms were seen (range 1-10 per patient) in a young patient population (median age 30 years). Nineteen patients had evidence o f advanced HIV infection. Aneurysms were atypically located and most freque ntly involved the carotid (24), superficial femoral (21) and popliteal (nin e) arteries. Twenty-five of the 31 symptomatic aneurysms were treated surgi cally. Surgical intervention comprised arterial vial reconstruction for 29 and aneurysm resection and ligation for the remainder. Histological examina tion revealed distinctive arteritic features. There were two treatment rela ted deaths, with short-term post-operative outcome being otherwise favourab le. Conclusions: HIV related aneurysms are characterised by their predilection for young patients, multiplicity, atypical location and their distinct hist ological features. Their increasing frequency reflects the unchecked advanc e of the HIV epidemic.