Clinical profile of HIV-related aneurysms

Objectives: to describe the clinical features, management, outcome and laboratory features of human immunodeficiency virus (HIV)-related aneurysms. Materials: twenty-eight HIV positive patients with arterial aneurysms treated 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 histological 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 of advanced HIV infection. Aneurysms were atypically located and most frequently involved the carotid (24), superficial femoral (21) and popliteal (nine) arteries. Twenty-five of the 31 symptomatic aneurysms were treated surgically. Surgical intervention comprised arterial vial reconstruction for 29 and aneurysm resection and ligation for the remainder. Histological examination revealed distinctive arteritic features. There were two treatment related deaths, with short-term post-operative outcome being otherwise favourable. Conclusions: HIV related aneurysms are characterised by their predilection for young patients, multiplicity, atypical location and their distinct histological features. Their increasing frequency reflects the unchecked advance of the HIV epidemic.