Abstract
The HIV/acquired immunodeficiency syndrome (AIDS) pandemic has affected the health status of the population in many countries. Early symptomatic HIV infection includes persistent generalized lymphadenopathy (PGL), which can be associated with opportunistic infections, e.g., toxoplasmosis and Cytomegalovirus (CMV) infection. This study followed the occurrence of PGL, toxoplasmosis, and Cytomegalovirus infection in 32 HIV-positive patients and analyzed the clinical signs of disease in relation to the number of CD4 T lymphocytes. In monitored patients, the average number of CD4 T lymphocytes was 940.8 ± 396.7/µL of blood. Severe immunodeficiency was recorded in four persons, who also suffered from colitis and/or retinitis and pneumonitis. The number of CD4 T cells in patients with PGL was significantly lower than that in patients without lymphadenopathy. In 6 (18.8%) IgM and 11 (34.4%) IgG Toxoplasma gondii seropositive patients, the number of CD4 T lymphocytes was significantly lower than that in seronegative patients. The presence of IgM and IgG antibodies to Cytomegalovirus was recorded in all examined patients, and CMV infection clinically manifested in five persons. The occurrence of PGL, the higher viral load, and seropositivity to T. gondii were significantly related to decline in the CD4 T lymphocyte number. The clinical course of the diseases was influenced by the status of the patient’s immunodeficiency and suggests ongoing immunosuppression and possible reactivation of both infections in all patients.
Highlights
The Human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) pandemic has severely affected health development and eroded improvements in life expectancy, in countries with the highest prevalence of infection
Human immunodeficiency virus (HIV) infection encompasses an acute phase that lasts for months, followed by a clinically latent phase that typically lasts for a few years and, by the collapse of immune system that characterizes acquired immunodeficiency syndrome (AIDS) [1]
All patients were on antiretroviral therapy (ART) for at least half a year
Summary
The HIV/AIDS pandemic has severely affected health development and eroded improvements in life expectancy, in countries with the highest prevalence of infection. Human immunodeficiency virus (HIV) infection encompasses an acute phase that lasts for months, followed by a clinically latent phase that typically lasts for a few years and, by the collapse of immune system that characterizes acquired immunodeficiency syndrome (AIDS) [1]. HIV infection includes persistent generalized lymphadenopathy (PGL), often the earliest symptom of primary HIV infection. HIV-infected population typically falls into one of three major categories: infection, malignancy, or reactive changes [3]. Different opportunistic infections such as tuberculosis, toxoplasmosis, disseminated fungal infections, atypical mycobacterial infections, Cytomegalovirus infection, etc., as well as immune reconstitution inflammatory syndrome (IRIS), may be associated with lymphadenopathy [4,5]
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