Lymphoreticular Involvement in Human Immunodeficiency Virus Infection

Although lymphadenopathy, hepatomegaly and splenomegaly are commonly seen in human immunodeficiency virus (HIV) infection, little is known about the prognostic significance of these findings.

A retrospective study of lymphoreticular involvement in 612 HIV-positive patients was done.

Lymphadenopathy was found in 301 (49.18%), hepatomegaly in 102 (16.66%) and splenomegaly in 58 (9.47%) patients. Sixty eight (32.54%) of the 209 patients with only lymphadenopathy had acquired immunodeficiency syndrome (AIDS), as compared to 70 (23.97%) of the 292 patients without lymphadenopathy or hepatosplenomegaly (χ(2) 4.49, df-1, p<0.05). There was a higher chance of having AIDS if hepatomegaly was present with lymphadenopathy. Eight (72.73%) of 11 patients with hepatomegaly alone, had AIDS. Thirty (68.18%) of 44 cases with splenomegaly, with lymphadenopathy and hepatomegaly, three (50%) of six cases having splenomegaly with lymphadenopathy and one (33.33%) of three cases with splenomegaly had AIDS. Majority of lymphoreticular involvement cases were due to Mycobacterium tuberculosis infection. All 29 cases with abdominal lymphadenopathy and one with hilar lymphadenopathy had AIDS. Bilateral discrete cervical, axillary and inguinal lymphadenopathy was the most common presentation. CD4 counts were significantly (p<0.05) lower in those with lymphadenopathy and hepatosplenomegaly.

HIV cases with lymphadenopathy and hepatomegaly should be investigated for the presence of opportunistic infection.