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Published on: October 12, 2018
Review of HIV-Related Cytopathology
Tee U Lang1, Walid E Khalbuss, Sara E Monaco
1Department of Pathology, University of Pittsburgh Medical Center Cancer Pavilion, 5150 Centre Avenue, Suite 201, Pittsburgh, PA 15232, USA.
Insights
Cytopathology is crucial for managing human immunodeficiency virus (HIV) patients. With longer lifespans due to therapy, HIV patients now face more non-HIV-defining cancers and drug side effects, shifting diagnostic focus.
Area of Science:
- Cytopathology
- Human Immunodeficiency Virus (HIV) Medicine
- Oncology
Background:
- Cytopathology plays a vital role in managing patients with human immunodeficiency virus (HIV) infection.
- Common samples include cervicovaginal, anal Papanicolaou tests, fine needle aspirations, respiratory specimens, body fluids, and tissue preparations.
- The landscape of HIV-related diseases is shifting due to effective antiretroviral therapy, leading to fewer opportunistic infections.
Purpose of the Study:
- To highlight the evolving spectrum of cytopathologic findings in human immunodeficiency virus (HIV)-infected patients.
- To emphasize the importance of recognizing non-HIV-defining cancers and drug-related side effects in this population.
- To underscore the utility of fine needle aspiration and anal Papanicolaou tests in HIV-related cytopathology.
Main Methods:
- Review of common exfoliative and aspiration cytology sample types in HIV-positive individuals.
- Analysis of the changing patterns of HIV-related diseases, including opportunistic infections, non-HIV-defining cancers, and drug-induced conditions.
- Focus on diagnostic techniques like fine needle aspiration and Papanicolaou tests for screening and evaluation.
Main Results:
- HIV patients are living longer, experiencing fewer opportunistic infections, and developing more non-HIV-defining cancers (e.g., anal cancer, Hodgkin's lymphoma).
- Drug side effects are leading to new cytopathologic entities (e.g., gynecomastia).
- Fine needle aspiration and anal Papanicolaou tests are increasingly important diagnostic tools.
Conclusions:
- Cytopathologists must adapt to the evolving spectrum of diseases in HIV-infected patients.
- Increased vigilance for non-HIV-defining malignancies and drug-related effects is necessary.
- Cytopathology remains essential for the diagnosis and management of HIV-associated conditions.
Abstract:
Exfoliative and aspiration cytologies play a major role in the management of patients with human immunodeficiency virus infection. Common cytology samples include cervicovaginal and anal Papanicolaou tests, fine needle aspirations, respiratory specimens, body fluids, Tzanck preparations, and touch preparations from brain specimens. While the cytopathologists need to be aware of specific infections and neoplasms likely to be encountered in this setting, they should be aware of the current shift in the pattern of human immunodeficiency virus-related diseases, as human immunodeficiency virus patients are living longer with highly active antiretroviral therapy and suffering fewer opportunistic infections with better antimicrobial prophylaxis. There is a rise in nonhuman immunodeficiency virus-defining cancers (e.g., anal cancer, Hodgkin's lymphoma) and entities (e.g., gynecomastia) from drug-related side effects. Given that fine needle aspiration is a valuable, noninvasive, and cost-effective tool, it is frequently employed in the evaluation and diagnosis of human immunodeficiency virus-related diseases. Anal Papanicolaou tests are also increasing as a result of enhanced screening of human immunodeficiency virus-positive patients for cancer. This paper covers the broad spectrum of disease entities likely to be encountered with human immunodeficiency virus-related cytopathology.
