generalized lymphadenopathy related to HIV

1. Generalized
lymphadenopathy related
to (HIV)

2. Medical history of the patient
• Unprotected sexual intercourse, especially receptive anal intercourse
(8-fold higher risk of transmission).
• A large number of sexual partners.
• Prior or current sexually transmitted diseases (STDs): Gonorrhea and
chlamydia infections increase the HIV transmission risk 3-fold.
• Sharing of intravenous drug.
• Receipt of blood products.
• Mucosal contact with infected blood or needle-stick injuries.

3. The patient may present with signs and
symptoms of any of the stages of HIV infection
1- Acute seroconversion manifests as: a flu like illness, consisting of fever,
malaise, and generalized rash.
2- asymptomatic phase :Generalized lymphadenopathy is common and may
be a presenting symptom.
Along with the enlargement of the lymph nodes symptoms of fever, rash,
myalgia, pharyngitis, hepatomegaly, splenomegaly and
malaise are also frequent.
3- Clinical AIDS: dementia/encephalopathy

5. Lymph node examination
Generalized Lymphadenopathy of HIV itself:
Early stage:
• Size: symmetrical enlargement of lymph node due to reactive
hyperplasia.
• Pain and tenderness: not tender lymph node .
• Consistency: firm in consistency.
• Location: Generalized Lymphadenopathy .
• Mobile lymph node.

6. • It is well known that there is an association of HIV with a several types of tumors and infections which
make us encounter a lot of patterns of lymphadenopathy:
A-Lymphadenopathy of opportunistic infections
HIV-LA in tuberculosis.
HIV-LA in/and Pneumocystis jirovecii .
HIV-LA in cytomegalovirus.
B-Lymphadenopathy as a result of malignancies
HIV-LA in kaposi’ sarcoma.
HIV-LA in Hodgkin lymphoma .
Late stage:
as the disease progress the architecture of lymph nodes becomes
disrupted and regression of the size of these nodes .

7. Investigations
1-CD4 T-cell count
1- A normal CD4 count can range from 500 cells/mm3 to 1000
cells/mm3.
2- When the CD4 count is more than 200 cells/mm3 and less than
500 cells/mm3 it is called (AIDS related complex ).
3- When the CD4 count drops below 200, a person is diagnosed with
AIDS is called (clinical AIDS) .

8. 2-Serological testing
• enzyme-linked immunosorbent assay (ELISA)
• simple/rapid test devices
• western blot (WB) tests.