Endobronchial primary large B-cell Non-Hodgkin lymphoma in HIV-infected patient in the Highly Active Antiretroviral Therapy era: Description of a case report.

We report an unusual case of endobronchial primary large B-cell Non Hodgkin Lymphoma in a HIV-infected patient in the course of effective Highly Active Antiretroviral Therapy (HAART). Diagnosis of large B-cell NHL was obtained by fibreoptic bronchoscopy (FOB) biopsies. Three cycles of R-CHOP chemotherapy (rituximab, vincristine, cyclophosphamide, hydroxydaunorubicin, prednisone) was performed and clinical and radiological remission was obtained after 3 cycles of therapy.

HCV and GBV-c/HGV infection in HIV positive patients in southern Italy.

Flaviviridae-hepatitis C virus (HCV) and GB virus C/hepatitis G virus (GBV-C/HGV)--and human immunodeficiency virus (HIV) frequently show similar modes of transmission. HCV and GBV-C/HGV infection was assessed in 134 consecutive patients with evidence of HIV infection, living in Campania, Italy. Data obtained from this cohort were compared with those obtained from 252 age- and sex-matched HCV infected patients without evidence of HIV infection (HCV control group). Following enzymatic immunoassays, samples were tested for the presence of HCV-RNA by RT-PCR. The HCV-RNA positive sera were genotyped by LiPA procedure. The prevalence of HCV infection in HIV patients was 19.40% and the largest group of HIV-HCV co-infected patients (84.62%) was represented by intravenous drug users (IVDU). The distribution of HCV genotypes in HIV-HCV patients was different, compared to that observed in HCV control group. HCV genotypes la (50%) and 3a (23.08%) were more frequently detected in HIV HCV patients, compared to HCV control group (5.16 and 5.56% for la and 3a, respectively). Conversely, HCV genotypes lb (55.70%) and 2a/2c (30.26%) were more represented in HCV control group, compared to HIV-HCV patients (15.38 and 0% for lb and 2a/2c, respectively). GBV-C/HGV seroprevalence was 41.04% in HIV patients and 6.54% in healthy control individuals. Differently from HCV, GBV-C/HGV infection did not correlate to a preferential risk behaviour in the HIV cohort. Comparative analysis of HCV and GBV-C/HGV infection indicates that the use of injecting drugs might play a key role in the epidemiology of HCV and, in particular, of la and 3a HCV genotypes, in HIV patients.

[Scintigraphy with gallium-67 citrate in patients with AIDS: pathologic extrapulmonary uptake]. / Scintigrafia con 67Gallio-citrato in pazienti con AIDS: captazione patologica extrapolmonare.

67Gallium citrate can accumulate in different inflammatory and neoplastic lesions. The mechanisms of 67Gallium uptake in abnormal tissue are still partially unknown and the tracer is considered a nonspecific indicator of disease. In AIDS patients, 67Gallium citrate is used in the diagnosis and characterization of opportunistic pulmonary infections and especially of Pneumocystis carinii pneumonia. From June 1989 through December 1992 in our Department 140 67Gallium scans were performed on 103 AIDS patients, referred for evaluation of pulmonary symptoms. All studies were carried out 72 hours after i.v. administration of 185 MBq 67Gallium citrate, with anterior and posterior views of head, chest and abdomen. The images were evaluated with conventional diagnostic criteria and site, number and intensity of abnormal foci of extrapulmonary uptake were recorded. Abnormal extrapulmonary uptake was found in 17 patients (12%): gastric (3, two of which also exhibited abnormal intestinal uptake), esophageal (1) hepatic (1), intestinal (2) renal (4), nodal (3), ocular (1), cutaneous (1), sinusal (1) localizations. In all cases clinical, endoscopic, bioptic or microbiological demonstration of the possible cause of 67Gallium uptake was obtained. An intriguing finding in our series was the lower incidence of gastric uptake (two patients with miliary tuberculosis and one patient with gastric candidiasis) than in the literature. This finding could be explained by clinical and epidemiologic differences between different patient populations. However, the scan interval after tracer administration should be also taken into account, since in our study scans were always performed at 72 hours, while in other series the interval ranged 24-48 hours. The relatively high incidence of abnormal extrapulmonary uptake confirms the opportunity of whole body exploration after 67Gallium administration in the patients with such multisystemic disease as AIDS, even when the patients are referred mainly for respiratory problems.

The lack of correlation between the positivity of anti-platelet antibodies and the presence of thrombocytopenia in course of HIV infection.

The presence of anti-platelet autoantibodies has been reported in many cases of HIV infection, but there is no accordance about their pathogenic role in the onset of thrombocytopenia in the patients studied. In the present study surface anti-platelet antibodies (PAIgG) and serum anti-platelet antibodies (sPAIgG) were assayed in a group of 135 HIV-infected patients (109 men, 26 women), in different clinical stages by using an immunofluorescence test (PSIFT). In order to investigate the possible correlation of the positivity of these autoantibodies and the onset of thrombocytopenia, some of these patients were controlled in a follow-up study, with two successful controls: 10 months (II control: 89 patients) and 20 months (III control: 59 patients) after the first time. In the I control PAIgG were positive in 68 subjects (50.4%) and sPAIgG in 34 (25.2%); both PAIgG and sPAIgG were present in 23 patients (17%). 56 patients did not present anti-plt antibodies (41.5%). No significantly different distribution of these autoantibodies in each stage of disease was observed. The mean value of platelet count resulted in the normal range both in the anti-plt antibody positive and in the anti-plt antibody negative patients, but the value found in the anti-plt antibody positive patients was significantly lower than the one found in the anti-plt antibody negative group (p < 0.01). This difference was more marked between the group with PAIgG and anti-plt antibody negative patients than between the group with sPAIgG and the anti-plt antibody negative patients (p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Isolated homonymous lateral hemianopsia revealing central nervous system toxoplasmosis as the initial manifestation of AIDS.

A 25-year-old-healthy man, with previous history of parenteral drug abuse, developed a left homonymous hemianopsia. Computed tomographic scanning showed a single ring enhancing lesion in the right parieto-occipital area. After the demonstration of seropositivity for human immunodeficiency virus and high serum immunoglobulin G antibody titer against Toxoplasma gondii, a diagnosis of cerebral toxoplasmosis in an AIDS patient was made. An isolated visual field defect revealing cerebral toxoplasmosis may be the first presentation of AIDS. Opportunistic cerebral lesions should be always considered in subjects at risk for AIDS who present focal neurological signs.