Etiological spectrum and diagnostic features of lymphadenopathy in People Living with HIV in French Guiana: A 17-years multicenter retrospective case series.

IF 3.4 2区 医学 Q1 PARASITOLOGY
PLoS Neglected Tropical Diseases Pub Date : 2025-09-22 eCollection Date: 2025-09-01 DOI:10.1371/journal.pntd.0013558
Morgane Bourne-Watrin, Ugo Françoise, Sophie Alexandra Baron, Antoine A Adenis, Dufens Pierre Louis, Loïc Epelboin, Mathieu Nacher, Félix Djossou, Kinan Drak Alsibai, Pierre Couppié
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Abstract

Introduction: Lymph node enlargement can be present at any stage of the HIV infection, reactive to HIV itself, another infection, or a malignant source. The aim of our study was to describe the causes of lymphadenopathy in the people living with HIV (PLHIV) of French Guiana, a French territory in the Amazon region.

Methods: A retrospective multicenter case series was conducted between January 2005 and December 2021. Inclusion population consisted of PLHIV who underwent a fine needle aspiration or a biopsy of a lymph node that was analyzed at the Department of Pathology of Cayenne hospital.

Results: We included 152 adults, with a median age of 43 [35-51] years and median CD4 count of 185/mm3 [60-344]. The main causes of lymphadenopathy were: histoplasmosis (25%, CI95%: 18-33), followed by tuberculosis (24%, CI95%: 18-32), HIV-reactive lymphadenitis (21%, CI95%: 15-29) and lymphoproliferative disorder (11%, CI95%: 7-18). Multiple causes were present in 6% of cases. Opportunistic infections represented 53% (CI95%: 44-61) of cases. The main characteristics associated with opportunistic disease (infectious or neoplastic) were lymph node > 5 cm, CD4 count < 200/mm3, hepatomegaly or splenomegaly and the presence of extra-ganglionic symptoms.

Conclusion: For the last 17 years, opportunistic infections represented 53% of the causes of lymphadenopathy among PLHIV. Histoplasmosis, already recognized as the first AIDS-defining condition and first cause of AIDS-related deaths in French Guiana, is also the first cause of lymphadenopathy in PLHIV, ahead of tuberculosis and reactive lymphadenopathy. The CD4 count and the size of the lymph nodes appear to be the most important factors in the diagnostic process and should lead to a quick lymph node analysis in these patients.

法属圭亚那艾滋病毒感染者淋巴结病的病因谱和诊断特征:17年多中心回顾性病例系列。
淋巴结肿大可以出现在HIV感染的任何阶段,对HIV本身、其他感染或恶性源有反应。我们研究的目的是描述法属圭亚那(亚马逊地区的法国领土)艾滋病病毒感染者(PLHIV)淋巴结病的原因。方法:2005年1月至2021年12月进行回顾性多中心病例系列研究。纳入人群包括在卡宴医院病理科进行细针穿刺或淋巴结活检的PLHIV患者。结果:我们纳入了152名成年人,中位年龄为43岁[35-51]岁,中位CD4计数为185/mm3[60-344]。淋巴结病的主要病因为组织胞浆菌病(25%,CI95%: 18-33),其次为结核(24%,CI95%: 18-32)、hiv反应性淋巴结炎(21%,CI95%: 15-29)和淋巴细胞增生性疾病(11%,CI95%: 7-18)。6%的病例存在多种原因。机会性感染占53% (CI95%: 44-61)。与机会性疾病(感染性或肿瘤性)相关的主要特征是淋巴结肿大5 cm, CD4计数。结论:在过去17年中,机会性感染占PLHIV患者淋巴结病变的53%。在法属圭亚那,组织胞浆菌病已经被认为是艾滋病的第一个定义疾病和艾滋病相关死亡的第一个原因,也是PLHIV患者淋巴病变的第一个原因,排在结核病和反应性淋巴病变之前。CD4计数和淋巴结的大小似乎是诊断过程中最重要的因素,应该对这些患者进行快速的淋巴结分析。
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来源期刊
PLoS Neglected Tropical Diseases
PLoS Neglected Tropical Diseases PARASITOLOGY-TROPICAL MEDICINE
自引率
10.50%
发文量
723
期刊介绍: PLOS Neglected Tropical Diseases publishes research devoted to the pathology, epidemiology, prevention, treatment and control of the neglected tropical diseases (NTDs), as well as relevant public policy. The NTDs are defined as a group of poverty-promoting chronic infectious diseases, which primarily occur in rural areas and poor urban areas of low-income and middle-income countries. Their impact on child health and development, pregnancy, and worker productivity, as well as their stigmatizing features limit economic stability. All aspects of these diseases are considered, including: Pathogenesis Clinical features Pharmacology and treatment Diagnosis Epidemiology Vector biology Vaccinology and prevention Demographic, ecological and social determinants Public health and policy aspects (including cost-effectiveness analyses).
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