THE SPECTRUM OF CLINICAL AND PATHOLOGICAL MANIFESTATIONS OF AIDS IN A CONSECUTIVE SERIES OF AUTOPSIED PATIENTS IN MEXICO

Objective: Little is known about the clinical profile of AIDS in Latin American populations. This study characterizes the clinical and pathological manifestations of AIDS in a representative series of Mexican AIDS patients at autopsy. Design: The clinical and pathological findings were abstracted retrospectively for a sequential series of autopsied AIDS patients. Setting. Autopsies were conducted at the four major tertiary level hospitals that serve the majority of AIDS patients in Mexico City. Patients: Subjects included 177 consecutive patients diagnosed with AIDS between March 1984 and january 1989 who subsequently died and were autopsied in the same period in the study hospitals. Main outcome measures: Demographic characteristics, including age, gender, residence, socioeconomic status, and risk group; clinical presentation and autopsy findings, including opportunistic infections and malignancies. Results: Sixty per cent of the AIDS patients presented with wasting syndrome. The most common infections were cytomegalovirus (69%), tuberculosis (25%), and Pneumocystis carinii pneumonia (24%). Central nervous system infections were also common and included toxoplasmosis (19%) and cryptococcuses (10%). Kaposi's sarcoma was present in 30% of cases and non-Hodgkin's lymphoma in 9%. Conclusion: Clinical manifestation, and types and frequency of opportunistic infections in our Mexican AIDS patients were more similar to those seen in AIDS patients in Africa and Haiti than in the United States and Europe. These findings suggest that the AIDS epidemic in Mexico has an 'intermediate' pattern and may be a prototype for Latin American countries.