Guihot A, Boulanger E, Galicier L, Zucman D, Rivaud E, Scherrer A, Agbalika F, Couderc LJ, Oksenhendler E; IAS Conference on HIV Pathogenesis and Treatment (2nd : 2003 : Paris, France).
Antivir Ther. 2003; 8 (Suppl.1): abstract no. 934.
Hopital Foch, Suresnes, France
Aim: To describe the pulmonary manifestations occuring in HIV-infected patients suffering from multicentric CD. METHODS: A retrospective study of the records of 11 patients with pulmonary symptoms out of a total of 66 patients with CD seen between 1990 and the end of 2001. RESULTS: Nine male and two female patients with a mean age of 45 yrs. Ethnic origin: Caucasian 8, African 3. None were IVDA; five males were homosexual. Previous AIDS-related infections: 5/11 cases. Previous Kaposi's sarcoma: five patients. Mean CD4 cell count: 273/mm3 and mean HIV viral load 3.4 log copies. All patients complained of general symptoms: fever 11/11 cases, malaise 10, weight loss 6. Most patients (10/11) exhibited peripheral lymphadenopathy (10), liver (10) or spleen (9) enlargement. The diagnosis of CD was previously performed in 10/11 patients by lymph-node biopsies in all cases. Pulmonary manifestations: interstitial pneumonitis 10 cases, with pleural effusion in two cases, and small mediastinal lymphadenopathies in five cases. One patient (without previous known diagnosis of CD) had a solitary pulmonary nodular opacity. The CD in this case was diagnosed by open-lung biopsy. Fiberoptic endoscopy was normal in all 10 cases. All microbi-ological tests remained negative. Clinical course and follow-up: Chemotherapies in eight patients (mainly etoposide and vinblastine); corticosteroids: four patients, anti-interleukin-6 antibody, one case, thalidomide, one case. The evolution was mainly characterized by 1$#176;) a dramatic improvement in less than 24 hours of the interstitial pneu-monitis, 2$#176;) a high frequency of relapse (38 attacks in the 10 patients with interstitial pneumonitis), 3$#176;) an association of the presence of the clinical attacks with a high HHV-8 viral load, 4$#176;) a high frequency of non Hodgkin's lymphoma (5 out of 11 patients) and haemophago-cytic syndrome (3 cases), 5$#176;) a poor prognosis: five deaths (of lymphoma in four cases). CONCLUSION: HIV-infected patients with CD have 1$#176;) a high frequency of pulmonary manifestations, mainly an acute febrile interstitial pneumonitis with frequent recurrence, 2$#176;) a good response to etoposide and 3$#176;) a poor prognosis related to the development of lymphoma.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Biopsy
- CD4 Lymphocyte Count
- Female
- Giant Lymph Node Hyperplasia
- HIV Infections
- HIV Seropositivity
- Humans
- Lung Neoplasms
- Lymphoma, Non-Hodgkin
- Male
- Retrospective Studies
- Sarcoma, Kaposi
Other ID:
UI: 102263212
From Meeting Abstracts