Abstract
Background and Aim: Human immunodeficiency virus (HIV) infection has become a global pandemic. Persistent generalized lymphadenopathy (PGL) is very common manifestation of HIV infection. Moreover, different opportunistic infections such as tuberculosis (TB) and malignancies may present with lymphadenopathy. This study was performed to evaluate the role of FNAC as a cytological investigative tool in the diagnosis of various lesions in HIV lymphadenopathy.
 Material and Methods: This study was carried out in Tertiary care Institute of India, over a period of one year. Total 50 cases of HIV lymphadenopathy patients were participated in the study after having signed the Informed Consent Form. Diagnosis of HIV was done by enzyme linked immunosorbant assay (ELISA) test, followed by the CD4 counts by BD FACS Count system in HIV positive patients. FNAC procedure was performed as an OPD procedure in cytology OPD of pathology department.
 Results: Most common site of HIV lymphadenopathy is cervical lymph node 40 (80%), followed by supraclavicular 6(12%) followed by axillary lymph node 4(8%). The most common lesion found was mycobacterial infection 22(44%), followed by reactive lymphadenitis 15(30%). Non-specific chronic granulomatous lymphadenitis in 10(22%) and 3(6%) cases of acute suppurative lymphadenitis. CD4 count more than 500 cells/ µL was seen in 9 (18%) cases of reactive lymphadenitis and 4 (8%) cases of chronic granulomatous lymphadenitis. Patients with tubercular infection had CD4 count between 200- 499 cells/ µL in 12 (24%) cases and less than 200 in 10 (20%) cases.
 Conclusion: FNAC is relatively inexpensive and valuable tool for identification of opportunistic infections, neoplastic lesions and non-neoplastic lesions. It may spare patients lymph node excision and enable immediate treatment of specific infection. This procedure is readily repeatable and can be used for follow up during and after treatment.
 Keywords: Human immunodeficiency virus, lymphadenopathy, Non-specific chronic granulomatous lymphadenitis, tuberculosis
Highlights
Acquired immunodeficiency syndrome (AIDS) is known to be caused by a lymphotropic retro-virus ie.Human immunodeficiency virus (HIV), first described by French investigators and later by investigators in United States
AIDS was first recognized in 1981.1 Acquired Immuno Deficiency Syndrome (AIDS) related lymphadenopathy has definite patterns like florid reactive hyperplasia, folliculolysis, explosive follicular hyperplasia, advanced lymphocytic depletion with or without abnormal regressively transformed germinal centers and vascular transformation
Human Immunodeficiency Virus (HIV) disease can be divided on the basis of immunodeficiency into an early stage [cluster of differentiation (CD)4 > 500/μL], an intermediate stage (CD4 = 200-500/μL), and an advanced stage (CD4 < 200/μL).[2,3]
Summary
Acquired immunodeficiency syndrome (AIDS) is known to be caused by a lymphotropic retro-virus ie.Human immunodeficiency virus (HIV), first described by French investigators and later by investigators in United States. HIV disease can be divided on the basis of immunodeficiency into an early stage [cluster of differentiation (CD)4 > 500/μL], an intermediate stage (CD4 = 200-500/μL), and an advanced stage (CD4 < 200/μL).[2,3] Most AIDS-defining opportunistic infections and malignancies occur in the advanced stage of the disease. AIDS is a fatal illness that breaks down the body's immunity and leaves the victim vulnerable to life threatening opportunistic infections, neurological disorders or unusual malignancy.[6] Lymphoid tissue is a favorite target for the initial viral infection, subsequent opportunist infections and Human Immunodeficiency Virus (HIV) associate neoplasm.[7]
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