THE STUDY OF CO-RELATION BETWEEN CD4 COUNTS & LYMPH NODE FINE NEEDLE ASPIRATION CYTOLOGY IN HIV POSITIVE PATIENTS AT TERTIARY HEALTH CARE INSTITUTE IN WESTERN MAHARASHTRA

Dr. Prachi Bhaskar Gholap, Dr. Pradnya Bhimrao Saragade, Dr. Yadav Hanmantrao Chavan

Abstract


Background: Lymphadenopathy in HIV infection is very common. Apart from other causes of lymphadenopathy, HIV infection itself may
produce persistent generalized lymphadenopathy. The present study demonstrated the utility of Lymph Node (LN) cytology in the diagnosis and
segregation of lymphadenopathy cases in HIV positive cases to aid clinical management.
Aims:
1. To find out various pathological changes in lymph node by fine needle aspiration cytology (FNAC) in HIV positive patients.
2. To find various types of lymph node lesions according to CD4 count in HIV positive patients.
3. To study co-relation of CD4 count with lymph node Fine needle Aspiration Cytology in HIV positive patients.
Materials & Methods: Present prospective study was conducted in the department of Pathology, over a period of one & half years. Study included
HIV positive patients referred for FNAC of enlarged LNs. Patients below 15 years of age were excluded.
Statistical Analysis used: Statistical analysis was carried out for difference in CD4 counts in five subgroups of reactive lymphadenitis, acute
inflammatory lesion, granulomatous lymphadenitis, TB lymphadenitis and lymphoma by Chi Square Test
Results: Total 118 aspirations were obtained, out of which 115 (97.5 %) had HIV-1 infection. Cervical LN was most commonly involved in 57 (48.3 %)
cases. Out of total 118 cases, 50 (42%) had tuberculous (TB) lymphadenopathy, followed by reactive lymphadenitis 35 (29.6 %). Analysis of difference
in CD4 counts in five subgroups of reactive lymphadenitis, acute inflammatory lesion, granulomatous lymphadenitis, TB lymphadenitis and lymphoma
was statistically significant (p <0.05). Out of 118 patients majority 51 (43.2 %) patients had CD4 values >500 cells/ μl.
Conclusion: FNAC is the primary and safe investigative procedure for lesions of the LNs in HIV positive patients and in many cases; it obviates the
need for excision, guides subsequent therapy or observation.


Keywords


HIV, Lymph node, CD4 count, FNAC

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References


K. Park: Park’s Textbook of Preventive and Social Medicine, 21st edition: AIDS, pp 316.

Department of AIDS control, Ministry Of Health and Family Welfare; Annual report 2010 -11; http:// nacoonline.org. Accessed on 30/9/11.

Mark Cichocki RN. What are CD4 cells? Why are they important to people living with HIV? http://www.About.com AIDS / HIV: Updated: August 06, 2007.

Guidelines on HIV testing, Ministry of Health and Family Welfare, National AIDS control Organization, March 2007.

Fauci AS, Lane HC: Human immunodeficiency virus disease: AIDS and related disorders. In: Harrison’s principles of internal medicine. 16th edition. Kasper DC, Fauci AS, Longo DL, Braunwald E, Hauser SL, Jameson IT, editors. United States of America, Mc Graw- Hill companies, 2005, p 1076- 1139.

Bottles K, Mc Phaul LW, Volberding P: Fine needle aspiration biopsy of patients with acquired immunodeficiency syndrome (AIDS): experience in an outpatient clinic. Ann Int Med. 1988; 108:42 – 45.

Martin Bates E, Tanner A, Suvarna SK, Glazer G, Coleman DV : Use of fine needle aspiration cytology for investigating lymphadenopathy in HIV positive patients. J ClinPathol. 1993; 46:564 – 566.

Shobhana A, Guha SK, Mitra K, Dasgupta A, Negi DK, Hazra SC. People living with HIV infection / AIDS: A study on lymph node FNAC and CD4 count. Indian J Med Microbiol 2002; 2:99- 101.

Vanisri HR, Nandini NM, Sunita R: Fine Needle Aspiration Cytology findings in human immunodeficiency virus lymphadenopathy. Indian Journal of Pathology and Microbiology: 2008; 51 (4):481-84.

Kumarguru, Kulkarni MH, Kamakeri NS : FNAC of peripheral lymph nodes in HIV positive patients. Scientific Medicine 2009; 1(2).

Shenoy R, Kapadi SN, Pai KP, Kini H, Mallya S, Khadilkar UN, et al: Fine needle aspiration diagnosis in HIV related lymphadenopathy in Mangalore, India. Acta Cytol.2002; 46:35 -39.

Jayaram G, Chew MT: Fine needle aspiration cytology of lymph nodes in HIV – infected individuals. ActaCytol. 2000; 44: 960 – 966.

Satyanarayana S, Kalghatgi AT, Murlidhar A, Prasad RS, Jawed KZ, Trehan A: Fine needle aspiration cytology of lymph nodes in HIV infected patients”. Med J Armed Forces India 2002; 58: 33-7.

Strigle SM, Rarwick MV, Cosgrove MM, et al. A review of fine needle aspiration cytology findings in human immunodeficiency virus infection. Diagn. Cytopathol. 1992:41- 42.

Grossl NA, Mosunjac MI, Wallace TM: Utility of fine needle aspiration in HIV positive patients with corresponding CD4 counts. Four years experience in a large inner city Hospital. Acta. Cytol. 1997; 41:811-816.

Reid AJC, Miller RF, Kocjan GL: Diagnostic utility of fine needle aspiration (FNA) cytology in HIV infected patients with lymphadenopathy. Cytopathology.1998; 9: 230 – 239.

Saikia UN, Dev P. Jindal B: Fine Needle Aspiration Cytology in lymphadenopathy of HIV positive cases. Acta Cytol.2001;45:589 – 592.

Nayak S, Mani R, Kavatkar AN, Puranik SC, Holla VV. Fine Needle Aspiration Cytology in lymphadenopathy in HIV positive patients. Diagn. Cytopathol. Vol 29 (3): doi: 10.1002/dc 10340. Sept 2003; pp 146-148.


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