Human Immunodeficiency Virus ELISA Research Articles

Comparison of human immunodeficiency virus and syphilis results in pooled sera versus individual samples of blood donors attending suez canal university hospital

Egypt is one of the countries where sexually transmitted diseases like human immunodeficiency virus (HIV) and syphilis are least prevalent. HIV and syphilis count less than one percent of total Egyptian population. An ELISA protocol for pooling serum samples is simple and may provide a way to reduce the cost and time needed for analysis. This study aimed to investigate the applicability and reliability of testing pooled sera of blood donors for HIV and syphilis compared to testing their individual sera and to assess the cost-effectiveness of this procedure. The study included 75 sera from randomly selected blood donors attending Suez Canal University hospital. Sera were screened by two ELISA kits, HIV Ag-Ab ELISA kit, and syphilis total antibody ELISA kit. Screening protocols were done by two sequential steps. At first, samples in pools of five were screened for both HIV and syphilis then, samples in positive pools were individually retested. There was no significant difference between the mean optical density for samples tested HIV and syphilis positive either individually or in pooled sera. There was no difference between the number of individual sera, tested positive for both HIV and syphilis and their pooled sera results (100 % positivity). There was significant decrease of the mean cost in one pool of 5 samples (16.5 L. E) in comparison to 5 individual samples (82.5 L. E) by HIV ELISA. Also, there was significant decrease of the mean cost in one pool of 5 samples (16 L.E) in comparison to 5 individual samples (80 L.E) by syphilis ELISA. In conclusion, the studied pooling protocol appeared reliable and can save up to 80 % of the cost for testing either HIV or syphilis by regular procedures.

Prevalence of HIV Infection among Pregnant Women attending Antenatal Clinics at a Tertiary Care Hospital in Hardoi, Uttar Pradesh: A Retrospective Observational Study

Introduction: Determining the seroprevalence of Human Immunodeficiency Virus (HIV) in pregnant women offers essential data for monitoring the trend of HIV and assists in prevention from mother-to-child transmission. Aim: To determine the prevalence of HIV infection among pregnant women. Materials and Methods: A retrospective observational study was conducted at Autonomous State Medical College, Hardoi, Uttar Pradesh, India from July 2016 to June 2019. A total of 6,974 pregnant females were referred to the antenatal clinic during the study period, and all were included in this study. HIV antibodies were tested using the three ELISA/Rapid/Supplemental tests protocol. A woman was identified as HIV infected if tested positive on more than two HIV ELISA tests. The data were entered into MS Excel and analysed using Statistical Package for the Social Sciences (SPSS) version 22.0. A Chi-square test was employed to assess the association between the variables. Results: Out of 6,974 females, a total of 32 (0.46%) pregnant females were found to be seropositive (13 patients from July 2016 to June 2017, 10 patients from July 2017 to June 2018, and 9 patients from July 2018 to June 2019). Among the 32 HIV-positive pregnant women, 2 (6.3%) were aged <20 years, 19 (59.4%) were aged 21-30 years, 9 (28.1%) were aged 31- 40 years, and 2 (6.2%) were aged over 40 years. Illiteracy was associated with seropositivity, as 53.1% of seropositive patients were illiterate. Conclusion: Seroprevalence has been decreasing in recent years, indicating that we are on the right track. However, efforts should be made to provide universal access to antenatal care and services for prevention parent-to-child transmission of HIV/AIDS.

Comparison of different rapid screening tests and ELISA for HBV, HCV, and HIV among healthy blood donors and recipients at Jibla University Hospital Yemen

Blood transfusion is associated with many risks, especially exposure to blood transfusion-transmitted infections considered one of the main causes of death worldwide, including hepatitis B (HBV) and C virus (HCV) and human immunodeficiency virus (HIV). The threat posed by blood-borne pathogens is disproportionately high, especially in developing countries, so there is a need for continuous monitoring of blood transfusions to prevent transmitting diseases. Rapid diagnostic immunochromatographic technique (ICT) methods are the most widely used methods in developing countries, although ELISA and molecular testing are considered more accurate worldwide. Therefore, the study aimed to compare the analytical sensitivity between rapid tests and the ELISA method for detecting HBV, HCV, and HIV infection among blood donors. Four hundred (400) blood donor samples were tested using the Rapid Test Kits (INTEC, SD, ABON, and CLUN), and the ELISA method was used as a confirmatory test. Out of 400 blood samples tested for viral infection, HBV, HCV, and HIV were detected in 8, 10, and 2 samples, respectively, using the ELISA technique. This study observed that the rate of sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), in addition to determining the diagnostic accuracy rate and error rate for all rapid diagnostic kits in detecting HBV, HCV and HIV are less accurate and associated with more false negatives compared to the ELISA technique. This study showed a significant difference in sensitivity between ELISA and rapid diagnostic immunochromatographic technique (ICT) groups; therefore, rapid diagnosis is not suitable for testing the quality of infectious markers for blood donors.

Correlates of transfusion transmissible infections among patients with sickle cell disease in Nigeria: case-control study

ABSTRACT Transfusion transmissible infections (TTIs) such as Hepatitis B Virus (HBV), Hepatitis C Virus (HCV) and Human Immunodeficiency Virus (HIV) are among the most frequent complications in individuals with Sickle Cell Disease (SCD). We investigated factors associated with TTIs in SCD patients and controls in South-west Nigeria. A total of 2,034 participants with or without SCD were recruited in a matched case-control study. HIV, HBV and HCV infections were diagnosed using commercialy available ELISA kits (Biorad, Paris). Samples positive for HIV ELISA were further confirmed using Western blot. Data were analyzed using descriptive statistics, paired/independent t-test and logistic regression at p = .05. Proportion with HBV was higher among those with multiple sexual partners (12.7%), tattoo/body incision (11.8%), and sharing of sharp objects (7.3%), but HIV was only higher among participants with history of tattoo/body incision (1.5%). Prevalence of TTIs was similar among participants with or without transfusion. History of sharing sharp objects (adjusted odds ratios (aOR) = 1.72; 95%CI:1.11–2.66) and tattoo/body incision (aOR = 1.89; 95%CI:1.22–2.94) almost doubled the risk of HBV. TTIs are endemic in the studied area. Certain lifestyles predispose people to TTIs than having blood transfusion. Population-based intervention targeting lifestyle changes may reduce the risk of TTIs in the study area. Abbrveviations AA: Hemoglobin AA; AC: Hemoglobin AC; aOR: adjusted Odds Ratios; AS: Hemoglobin AS; CHOP: Children Outpatient; CI: Confidence Interval; EDTA: Ethylenediamine Tetraacetic Acid; GOP: General Outpatient; HBV: Hepatitis B Virus; HCV: Hepatitis C Virus; HIV: Human Immunodeficiency Virus; HPLC: High Performance Liquid Chromatography; IAMRAT: Advanced Medical Research & Training; IDU: Injection Drug Use; MOP: Medical Outpatient; SC: Hemoglobin SC; SCD: Sickle cell disease; SD: Standard Deviation; SF: Hemoglobin SF; SS: Hemoglobin SS; STDs: Sexually Transmitted Diseases; TTI: Transfusion transmissible infections; UCH: University College Hospital Ibadan; UI: University of Ibadan;

Tuberculous Lymphadenitis in Immunocompromised Patients: A Case Report

Introduction: Tuberculous lymphadenitis (TBLN) is a form of extra-pulmonary TB with clinical features ranging from lumps to abscesses. Human Immunodeficiency Virus (HIV) co-infection and diabetes mellitus alongside TBLN made the diagnosis and management exceptionally challenging. We reported 3 cases of TBLN, 2 among them had an existing HIV co-infection, and 1 had preexisting diabetes mellitus.Case: The first case, a 28-year-old man, previously diagnosed with HIV, complained of a lump in the neck; biopsy results suggested TBLN. The second case was a 36-year-old man with a neck abscess and HIV co-infection. Acid Fast Bacilli (AFB) pus was positive & Human Immunodeficiency Virus Enzyme-Linked Immunosorbent Assay (HIV ELISA) was reactive. The third case was a patient with a neck abscess with preexisting diabetes mellitus (DM) underwent wound debridement and was given anti-tuberculosis drugs.Conclusion: TBLN with HIV co-infection or diabetes had clinical features ranging from a painful lump to an abscess. The definitive diagnosis was taken by examining AFB from pus. If the abscess was more extensive than or equal to 3 cm, wound debridement was necessary. The primary treatment for TBLN was anti-tuberculosis drugs and required even greater attention if a patient had any preexisting comorbidities such as HIV and diabetes.

Transfusion Transmissible Viral Infections Risk at Two Teaching Hospitals Blood Banks in Nigeria

Background/ Objectives: Transfusion Transmissible viral infections such as HIV, HBV and HCV are infectious agents that can pose a threat to blood safety. The aim of this study is to determine the prevalence and coinfection of Hepatitis B Virus (HBV), Hepatitis C Virus (HCV) and Human Immunodeficiency Virus (HIV) among blood donors tested negative to these viruses by rapid test devices. Materials and Methods: Two hundred and twelve (212) healthy blood donors (108 and 104 from UATH and NAUTH respectively) certified fit for blood donation were recruited for this study. One hundred and nine eighty (198) samples that were seronegative for HBsAg, HIV, HCV and Syphilis by rapid test were examined for the presence of HBsAg, Anti-HCV and HIV (Ab + Ag) using 4TH generation ELISA. Qualitative conventional PCR was used to confirm ELISA positive sera for HBV DNA, HIV RNA and HCV RNA. Results: Out of 198 blood donor samples negative for HBV, HCV and HIV by rapid test, 13.7%, 13.7% and 8.1% were positive by ELISA for HBV, HIV and HCV respectively. Twelve samples (6.1%) have coinfection of TTIs. One (1) sample out of the 12 samples is co-infected with these three viral (HBV, HCV and HIV) agents. Of the 28 samples positive for HBV by ELISA, 20 (71.4%) were positive for HBV DNA, 8 (36.4%) of 22 positive samples by HIV ELISA were positive for HIV RNA and 4 (28.6%) of 14 samples were positive for HCV RNA (p=0.0001). Conclusion and Recommendations: There is a high prevalence of transfusion transmissible viral infections among blood donors at our study population. This study therefore recommends blood donors in these Hospitals in particular and Nigeria in general be screened for HIV, HCV and HBsAg using ELISA 4th generation test kits and Nucleic Acid Testing (NAT).

Comparison between the accuracy of a rapid point-of-care HIV test TOYO versus ELISA, Western Blot, and RT-PCR analysis

Background: The human immunodeficiency virus (HIV) is considered one of the most serious health challenges worldwide. Early detection and diagnosis are key elements in the effort to control HIV. Rapid tests for the detection of HIV-antibody allow timely point-of-care provision of results and do not require the laboratory facilities needed for conventional enzyme immunoassays (enzyme-linked immunosorbent assay [ELISA]) and Western blot (WB) testing. Regardless of the advantages of these tests, other studies showed that the sensitivity of the performance of some rapid test brands comparing with the lab standard methods have some limitation. Objective: This study evaluated and compared the performance of commercially available HIV rapid test TOYO against the gold standard tests used in the clinical laboratories at Saudi Arabia. Materials and Methods: Forty-two male and female patient samples were tested with real-time polymerase chain reaction (RT-PCR), ELISA, and/or WB followed by TOYO rapid test to compare their results when performed under similar conditions. Results: The higher compatibility of TOYO results was observed with RT-PCR with 81% followed by WB and ELISA with 76% and 63%, respectively. However, more than 25% of the results showed either false positive or false negative results when compared with either of the standard diagnostic tests used in this study. Conclusion: This study have provided evidence that TOYO rapid HIV assay cannot perform equally as RT-PCR, ELISA, or WB for the detection of HIV antibodies. A further study is suggested to compare the performance of TOYO rapid test against standard diagnostic tests with larger number of patients’ samples.

Resistant Tremors and Unexplained Weight Loss Could Also Be a Sign of HIV

This case study is done to show a different type of presentation of a HIV (Human Immunodeficiency Virus) patient. Neurological symptoms in HIV are normally due to Progressive Multifocal Leukoencephalopathy (PML) which is a reactivated infection caused by John Cunningham virus (JC virus). The disease causes fatal demyelination of the central nervous system (CNS). This case presented a 51-year-old Nigerian man who complained of resistant tremors and unexplained weight loss. The patient was suspected to have HIV when a MRI scan revealed T2/FLAIR hyper intensity of white matter which was a sign of PML. HIV ELISA was done and came back with a positive result. PML presenting in the form of tremors is very rare and more research is required to focus on the neurological presentation of HIV.

Reappraisal of sexually transmitted infections in children: A hospital-based study from an urban area.

Sexually transmitted diseases (STDs) in children can be acquired either by sexual, or non-sexual route. Sexually transmitted infection (STI) in children reflect the pattern of STI in adult population and the knowledge, attitude and practices of the society. They also serve as an indicator of STI control strategies. A retrospective study spanning over a period of 5 years from 2007 to 2011) was undertaken to make a detailed analysis of demographic, behavioral, epidemiological and clinical profile of STD among children (<19 years). The medical records of children attending the STI clinic of Smt. Sucheta Kriplani Hospital from year 2007 to 2011 were studied. Results of Gram's staining, KOH examination, Tzanck smear, culture and serological tests like Venereal Disease Research Laboratory for syphilis and ELISA for human immunodeficiency virus (HIV) wherever performed were recorded along with the final diagnosis. The study showed a steady rise in the prevalence of STIs from 1% to 4.9% in the initial 4 years. STIs were more commonly observed in girls (M:F ratio - 1:1.13) and in adolescents >16 years of age. Homosexuality was present in 33.3% of males. History of sexual abuse was given by 4 children. 2 children were seropositive for HIV by ELISA technique. Viral STIs (Cyanea acuminata, molluscum contagiosum, herpes genitalis) were 1.5 times more common than bacterial infections. The societal sexual practices have undergone tremendous changes, which is reflected in a steady rise in STIs (predominantly viral), sexual abuse and homosexuality in children. There is an urgent need for strengthening of school health programs aiming at adolescent sexual health.

Reappraisal of sexually transmitted infections in children: A hospital-based study from an urban area

Background:Sexually transmitted diseases (STDs) in children can be acquired either by sexual, or non-sexual route. Sexually transmitted infection (STI) in children reflect the pattern of STI in adult population and the knowledge, attitude and practices of the society. They also serve as an indicator of STI control strategies.Aims:A retrospective study spanning over a period of 5 years from 2007 to 2011) was undertaken to make a detailed analysis of demographic, behavioral, epidemiological and clinical profile of STD among children (<19 years).Materials and Methods:The medical records of children attending the STI clinic of Smt. Sucheta Kriplani Hospital from year 2007 to 2011 were studied. Results of Gram's staining, KOH examination, Tzanck smear, culture and serological tests like Venereal Disease Research Laboratory for syphilis and ELISA for human immunodeficiency virus (HIV) wherever performed were recorded along with the final diagnosis.Results:The study showed a steady rise in the prevalence of STIs from 1% to 4.9% in the initial 4 years. STIs were more commonly observed in girls (M:F ratio - 1:1.13) and in adolescents >16 years of age. Homosexuality was present in 33.3% of males. History of sexual abuse was given by 4 children. 2 children were seropositive for HIV by ELISA technique. Viral STIs (Cyanea acuminata, molluscum contagiosum, herpes genitalis) were 1.5 times more common than bacterial infections.Conclusion:The societal sexual practices have undergone tremendous changes, which is reflected in a steady rise in STIs (predominantly viral), sexual abuse and homosexuality in children. There is an urgent need for strengthening of school health programs aiming at adolescent sexual health.

Combining rapid diagnostic tests and dried blood spot assays for point-of-care testing of human immunodeficiency virus, hepatitis B and hepatitis C infections in Burkina Faso, West Africa

AbstractPeople screened for human immunodeficiency virus (HIV) using rapid diagnostic tests (RDTs) in Africa remain generally unaware of their status for hepatitis B (HBV) and hepatitis C (HCV) infections. We evaluated atwo-step screening strategy in Burkina Faso, using both HIV RDTs and Dried Blood Spot (DBS) assays to confirm an HIV-positive test, and to test for HBV and HCV infections. HIV counselling and point-of-care testing were performed at a voluntary counselling and testing centre with HBV, HCV status and HIV confirmation using DBS specimens, being assessed at a central laboratory. Serological testing on plasma was used as the reference standard assay to control for the performance of DBS assays. Nineteen out of 218 participants included in the study were positive for HIV using RDTs. A fourth-generation HIV ELISA and immunoblot assays on DBS confirmed HIV status. Twenty-four out of 25 participants infected with HBV were found positive for hepatitis B surface antigen (HBsAg) using DBS. One sample with a low HBsAg concentration on plasma was not detected on DBS. Five participants tested positive for HCV antibodies were confirmed positive with an immunoblot assay using DBS specimens. Laboratory results were communicated within 7 days to participants with no loss to follow up of participants between the first and second post-test counselling sessions. In conclusion, DBS collection during HIV point-of-care testing enables screening and confirmation of HBV, HCV and HIV infections. Diagnosis using DBS may assist with implementation of national programmes for HBV, HCV and HIV screening and clinical care in middle- to low-income countries.

Positive HIV ELISA test, autoimmune hemolytic anemia, and generalized lymphadenopathy: A unifying diagnosis

Positive HIV ELISA test, autoimmune hemolytic anemia, and generalized lymphadenopathy: A unifying diagnosis

Rapid versus standard testing for prenatal HIV screening in a predominantly Hispanic population

This study aimed to examine the false positive rate of the OraQuick rapid human immunodeficiency virus (HIV) test compared with the ELISA test in pregnant patients of low socioeconomic status. Blood samples from pregnant patients collected between 10 February 2005 and 1 June 2005 were tested with HIV ELISA and OraQuick rapid HIV tests. The positive predictive values of both tests were calculated. Of 910 patients, 14 (1.5%) patients had a positive HIV ELISA test, with only 5 patients confirmed for HIV. The positive predictive value for the ELISA test was 35.7% compared with 100% for the OraQuick rapid test. In a predominantly low socioeconomic Hispanic patient population with a 0.5% HIV prevalence, false positive HIV testing is lower for the OraQuick rapid HIV test compared with the HIV ELISA test. Implementation of the rapid HIV test would mitigate the emotional distress and unnecessary intrapartum and neonatal zidovudine treatments associated with false positive HIV testing.

HIV post-exposure prophylaxis in children and adolescents presenting for reported sexual assault

Background The appropriate use of antiretroviral medications to protect against infection with human immunodeficiency virus (HIV) is unclear in cases of sexual assault of children, for whom the perpetrator's risk of HIV is often unknown, and physical proof of sexual contact is usually absent. Objective In an effort to clarify prescribing practices for HIV post-exposure prophylaxis (PEP) at our institution, we examined records of all children tested for HIV for prevalence of infection, our experience with prescribing PEP, and follow-up rates. Design/methods Medical records at a sexual abuse clinic of all children tested for HIV during a 38-month period were reviewed for information concerning risk factors for HIV acquisition, STI test results, and PEP experience. Children were defined as PEP-eligible if they were within 96 hours of assault, and there was a report of sexual contact with the potential to transmit HIV. Results One thousand seven hundred and fifty children were tested for HIV during the study period. Five children had a positive HIV ELISA, but only one child was confirmed HIV-positive. Three hundred and three children were eligible to receive HIV-PEP, but it was only offered to 16 (5.3%), of whom 15 accepted the medications. None of the children prescribed PEP completed follow-up, but 11 children had limited follow-up. Conclusions Our results indicate that the prevalence of HIV infection among sexually abused children in our population is low, and follow-up rates are poor. Intensive efforts to try to ensure follow-up are warranted whenever PEP is prescribed. Further research may help better define the efficacy of PEP in sexually abused children and adolescents.

Opsoclonus–myoclonus–ataxia syndrome and HIV seroconversion

Sirs, Neurological disorders are a well-known complication of human immunodeficiency virus (HIV) infection [7]. An incidence of 2–3% of clinically relevant movement disorders has been identified in patients with HIV infection seen at tertiary referral centers, and in several cases it may represent the initial manifestation of HIV infection [8]. Nevertheless, the incidence of movement disorders increases significantly, ranging between 5 and 44% in AIDS patients, with a large prevalence of tremor and Parkinsonism [2, 8]. Opsoclonus–myoclonus–ataxia syndrome (OMAS) is a rare neurological disorder associated with many clinical settings [11]. Although the pathophysiology of opsoclonus is still undefined, a dysfunction at the pontine paramedian reticular formation (PPRF) and the cerebellum secondary to a dysregulation of the humoral and cell mediated immune mechanisms is postulated [11]. To our knowledge, OMAS has been previously reported in only two HIV patients [5, 9] but not at the time of seroconversion. We report a 44-year-old white man who was admitted 24 h after the onset of acute opsoclonus, truncal ataxia and orthostatic myoclonus that led to postural instability. His personal and family medical history was unremarkable, with the exception of a mild congenital right brachial paresis. Physical examination revealed involuntary, multidirectional, high-amplitude, conjugate saccadic eye movements. Gait was moderately unsteady, due to involuntary jerking of lower extremities and wide-base standing. The remainder of the neurological and systemic examinations were normal. The routine blood chemistry tests, including thyroid function, were normal but the liver chemistry tests showed elevated s-GOT (74 units/l) and s-GPT (185 units/ l). Serology for Epstein Barr virus, CMV, hepatitis A, B and C virus and VDRL were negative. An HIV antibody test performed 2 months before the onset of symptoms was negative, but two new HIV ELISA and a Western blot (IgG) tests performed 24 h and 48 h after admission showed positive, with a CD4 count of 511 cells/ml (17%) and a viral load of 1.5 9 10 (6.17 log) (NASBA methods). The CSF constituents, a brain MRI and EEG were normal. The patient’s symptoms improved with lorazepam 1 mg/ day and resolved completely after 1 week, but he refused antiretroviral therapy. Two additional viral load assessments and CD4 counts were obtained 1 month and 1 year later, respectively (Fig. 1). This case fulfills the clinical diagnostic criteria of OMAS. Its temporal occurrence and evolution suggest that this syndrome might be not only a random association but the clinical expression of the HIV seroconversion. The HIV seroconversion in this patient was supported by a negative HIV antibody test performed 2 months before the onset of OMAS, followed by a new HIV positive test at time of admission. In accordance with A. Ayarza V. Parisi D. Visconti G. Persi C. A. Rugilo E. M. Gatto Department of Neurology, Sanatorio de la Trinidad Mitre, Bartolome Mitre 2553, CP 1039, Buenos Aires, Argentina

Sexually transmitted infections, bacterial vaginosis, and candidiasis in women of reproductive age in rural Northeast Brazil: a population-based study

Population-based data on sexually transmitted infections (STI), bacterial vaginosis (BV), and candidiasis reflect the epidemiological situation more accurately than studies performed in specific populations, but such data are scarce. To determine the prevalence of STI, BV, and candidiasis among women of reproductive age from a resource-poor community in Northeast Brazil, a population-based cross sectional study was undertaken. All women from seven hamlets and the centre of Pacoti municipality in the state of Ceará, aged 12 to 49 years, were invited to participate. The women were asked about socio-demographic characteristics and genital symptoms, and thereafter examined gynaecologically. Laboratory testing included polymerase chain reaction (PCR) for human papillomavirus (HPV), ligase chain reaction (LCR) for Chlamydia trachomatis and Neisseria gonorrhoeae, ELISA for human immunodeficiency virus (HIV), venereal disease research laboratory (VDRL) and fluorescent treponema antibody absorption test (FTA-ABS) for syphilis, and analysis of wet mounts, gram stains and Pap smears for trichomoniasis, candidiasis, and BV. Only women who had initiated sexual life were included in the analysis (n = 592). The prevalences of STI were: HPV 11.7% (95% confidence interval: 9.3-14.7), chlamydia 4.5% (3.0-6.6), trichomoniasis 4.1% (2.7-6.1), gonorrhoea 1.2% (0.5-2.6), syphilis 0.2% (0.0-1.1), and HIV 0%. The prevalence of BV and candidiasis was 20% (16.9-23.6) and 12.5% (10.0-15.5), respectively. The most common gynaecological complaint was lower abdominal pain. STI are common in women in rural Brazil and represent an important health threat in view of the HIV pandemic.

A Case of Late-Onset Pedophilia To Sertraline

A Case of Late-Onset Pedophilia To Sertraline

Vulval cytomegalovirus coexisting with herpes simplex virus in a patient with human immunodeficiency virus infection

.We describe the cutaneous manifestation, diagnosis,management and outcome of vulval CMV and herpessimplex virus (HSV) infection in a patient with humanimmunodeficiency virus (HIV) infection.Case reportA 34 year old patient was referred to our institution fora non-healing vulval ulcer. The ulcer had been present fora year and was being treated as a bacterial infection at aprimary health care centre for which there was no re-sponse. She had no other significant history and clinicalexamination revealed a patient in good general andsystemic condition. External genital examination revealedan 8 5 cm ulcer of the left labia majora extending tothe left buttock region. The ulcer had a raw base andslightly raised edges (Fig. 1). Genital examination wasotherwise normal. Biopsy of the ulcer revealed ulcera-tion with underlying granulation tissue, a mixed inflam-matory cell infiltrate and scattered cells with largeintranuclear inclusions consistent with CMV. In addition,the squamous epithelium shows foci of intranuclear inclu-sions with syncytia formation consistent with HSV in-fection. An HIV ELISA antibody test was positive and theCD

Coincidental detection of T-cell rich B-cell lymphoma in the paraaortic lymph nodes of a woman undergoing lymph node dissection for cervical cancer

The diagnosis of cervical squamous cell carcinoma with concurrent T-cell rich B-cell lymphoma in dissected lymph nodes has not been reported to our knowledge. We report such a case. The biopsy of an exophytic lesion at the uterine cervix showed squamous cell carcinoma in a 50-year-old woman presenting with postcoital bleeding. Type III hysterectomy, bilateral salpingo-oophorectemy, bilateral pelvic, paraaortic lymph node dissections were performed. Pathologic examination revealed a T-cell rich B-cell lymphoma in some lymph nodes beside squamous cell carcinoma in several of others. ELISA for human immuno-deficiency virus (HIV) was negative. The cervical carcinoma was staged as FIGO clinical stage IB1 and the lymphoma as Ann Arbor IIA. Six cycles of CHOP (cyclophosphamide, adriamycin, vincristine, and prednisone) chemotherapy for the lymphoma and concomitant pelvic chemo-radiotherapy with cisplatin for cervical cancer were given. In this rare coincidence; the best available therapy for each of the diseases should be considered individually. We also suggest that HIV screening test be carried out, because both diseases may be related to human immuno-deficiency virus, although our patient was HIV-negative.

Coincidental detection of T-cell rich B-cell lymphoma in the paraaortic lymph nodes of a woman undergoing lymph node dissection for cervical cancer

The diagnosis of cervical squamous cell carcinoma with concurrent T-cell rich B-cell lymphoma in dissected lymph nodes has not been reported to our knowledge. We report such a case. The biopsy of an exophytic lesion at the uterine cervix showed squamous cell carcinoma in a 50-year-old woman presenting with postcoital bleeding. Type III hysterectomy, bilateral salpingo-oophorectemy, bilateral pelvic, paraaortic lymph node dissections were performed. Pathologic examination revealed a T-cell rich B-cell lymphoma in some lymph nodes beside squamous cell carcinoma in several of others. ELISA for human immuno-deficiency virus (HIV) was negative. The cervical carcinoma was staged as FIGO clinical stage IB1 and the lymphoma as Ann Arbor IIA. Six cycles of CHOP (cyclophosphamide, adriamycin, vincristine, and prednisone) chemotherapy for the lymphoma and concomitant pelvic chemo-radiotherapy with cisplatin for cervical cancer were given. In this rare coincidence; the best available therapy for each of the diseases should be considered individually. We also suggest that HIV screening test be carried out, because both diseases may be related to human immuno-deficiency virus, although our patient was HIV-negative.