CLINICO-PATHOLOGICAL CORRELATION OF LYMHADENOPATHY IN HIV POSITIVE PATIENTS

Abstract

Naveen K, Uday B. Nayak

ACKGROUND: Lymphadenopathy is common in HIV infected individuals as lymphoid tissue is a major target and reservoir of the Human immunodeficiency virus (HIV) as well for opportunistic infections. AIM: Clinical assessment of HIV positive patients with lymphadenopathy and its correlation with lymph node fine needle aspiration cytology (FNAC) and CD4 count. STUDY DESIGN: Cross sectional study of 100 HIV positive patients. MATERIALS AND METHODS: Clinical profile of 100 HIV positive patients with lymphadenopathy was taken. FNAC of the largest lymph node was done. Smears collected were stained by different staining techniques like papanicolou staining, H& E staining, Giemsa staining and AFB as well as PAS staining. FNAC finding was compared with the CD4 count. RESULTS: Of the 100 patients studied, maximum number of cases was reported in the age group of 31 to 40 years. Majority of the patients were males (81%). Most common presentations were fever in 71%, weakness in 71%, weight loss in 53% and lymph node swelling in 23% of patients. Most common site of lymph node involvement was cervical. FNAC of lymph nodes revealed that maximum number of cases had tuberculosis lymphadenitis (59%), followed by reactive hyperplasia (37%), nonHodgkin's lymphoma (2%), cryptococcosis (1%) and metastasis (1%). The mean value of CD4count was 461 for reactive hyperplasia, 294 for TB lymphadenitis, and 318 for others. Multiple comparisons of FNAC with CD4 count, revealed significant p-value between Tubercular lymphadenitis and Reactive hyperplasia. CONCLUSION: Low CD4 count is associated with Tubercular lymphadenitis and higher CD4count with Reactive hyperplasia.

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