Annunziato Maria Antonieta^1*, Sardiñas Carlos², Finol Hector³, Carvajal Ana⁴, González Roschman³, De Gouveia Yetsenia⁵, García Estefanie⁵, Garibaldi Liseth⁶

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¹ Department of Internal Medicine, Medical Attention Center, General Checkups, Medical Exams and Consultations, Wheelchair Center (BANDESIR), Caracas, Venezuela.
² Coloproctology Unit, Caracas University Hospital (HUC), Caracas, Venezuela.
³ Center for Electron Microscopy, Sciences Faculty, Central University of Venezuela, Caracas, Venezuela.
⁴ Department of Infectious Diseases, University Hospital of Caracas (HUC), Caracas, Venezuela.
⁵ School of Biology, Faculty of Sciences, Central University of Venezuela, Caracas, Venezuela.
⁶ Research Assistant Department of Electronic Microscopy, Venezuelan Institute of Scientific Research (IVIC), Altos de Pipe, Venezuela.
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Abstract: Objective: To determine the ultrastructural findings on Rectal Mucosa (RM) of patients with HIV/AIDS and anorectal pathologies (ARP), at micrometric and nanometric scales. Materials and methods: 5 patients were evaluated, 18 - 55 years old, with ARP (HIV co-infection with HPV, n = 4, and HIV-negative patient with HPV infection) (control n = 1), who were referred to the Coloproctology Unit of the HUC, and subjected to rectoscopy and biopsy. RM samples were identified, placed in a sterile plastic bottle with 1 mL of 2% glutaraldehyde and immediately transported for routine processing of fine cut (60 - 90 nm) to be evaluated via Transmission Electron Microscopy (TEM). They were fixed with Karnovsky solution with Millonig phosphate buffer (pH 7.4 and 320 mOsm) and post-fixed with OsO₄ under the same conditions of pH and osmolarity. Results: Ultrastructural findings, at 10^−6 scale: 1) Intestinal mucosa: vacuoles of mucus of different sizes that seem to be fused. 2) Smooth muscle cells: loss of definition of contractile myofilaments mass. 3) Unmyelinated axons and terminals of Schwann cells (SC): Edema and loss of their plasma membranes in some areas of association with axon terminals as well as abundant collagen fibers associated with SC. Ultrastructural findings, at 10^−9 scale: 1) Smooth muscle cells: folded wrapper cores and edema of mitochondria and rough endoplasmic reticulum cisterns (RER). 2) Myelinated axon terminals: Loss of synaptic vesicles. 3) Fibroblasts: One observes mitochondria and cisterns of RER with alterations. All these alterations can generate intestinal and anorectal dysfunction in these patients. Conclusions: The HIV causes changes in rectal and muscular mucosa despite HAART treatment with undetectable viral load.

Keywords: Anorectal Pathologies, HIV/AIDS, Transmission Electron Microscopy (TEM), Nanometric Scales, Rectal Mucosa, Caveolae, Endothelial Cell, Nano-Drugs

Cite this paper: Antonieta, A. , Carlos, S. , Hector, F. , Ana, C. , Roschman, G. , Yetsenia, D. , Estefanie, G. and Liseth, G. (2018) Ultrastructural Findings, at Micrometric and Nanometric Scales, in Rectal and Muscular Mucosa of Patients with HIV/AIDS and Anorectal Pathology. International Journal of Clinical Medicine, 9, 481-493. doi: 10.4236/ijcm.2018.95041.

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