People living with HIV infection / AIDS - a study on lymph node FNAC and CD4 count

Area of Science:

• Infectious Diseases
• Oncology
• Immunology

Background:

• Generalized lymphadenopathy is a common clinical manifestation in individuals with Human Immunodeficiency Virus (HIV) infection.
• The differential diagnosis of lymphadenopathy in HIV-positive individuals includes opportunistic infections and malignancies.
• Understanding the etiological spectrum of lymphadenopathy is vital for guiding appropriate diagnostic and therapeutic strategies.

Purpose of the Study:

• To investigate the causes of generalized lymphadenopathy in a cohort of HIV-seropositive individuals.
• To correlate the findings of fine-needle aspiration cytology (FNAC) with CD4+ T-cell counts in these patients.
• To determine the prevalence of tuberculous lymphadenitis and non-Hodgkin lymphoma in HIV-infected patients presenting with lymphadenopathy.

Main Methods:

• Retrospective analysis of 54 HIV-seropositive patients with generalized lymphadenopathy identified between July 1997 and December 2000.
• Fine-needle aspiration cytology (FNAC) performed on enlarged, non-inguinal lymph nodes.
• CD4+ T-cell counts were assessed in the study subjects.

Main Results:

• Reactive hyperplasia was the most common finding (55.5%), associated with higher CD4+ counts (median 670 cells/microL).
• Tuberculous lymphadenitis was diagnosed in 41% of cases, with lower CD4+ counts (median 212 cells/microL).
• Non-Hodgkin lymphoma was identified in 3.7% of patients with significantly reduced CD4+ counts (79-113 cells/microL).

Conclusions:

• Generalized lymphadenopathy in HIV-infected individuals frequently represents opportunistic infections or malignancies.
• FNAC is a valuable diagnostic tool for evaluating lymphadenopathy in HIV patients.
• Lower CD4+ counts are associated with a higher likelihood of opportunistic infections like tuberculosis and lymphoma.