Epidemiology of HIV infection and AIDS in Antigua - abstract

We analysed the clinicopathologic features of 111 patients with T-cell lymphoma in Jamaica. The lymphomas were classified histologically according to the recommendations of Rappaport, the National Cancer Institute (NCI) Working Formulation and the Lymphoma Study Group in Japan. Phenotypice classification was based on the results of immunohistochemical studies utilising a panel of monclonal antibodies directed against T and B lymphocytes. Serum samples were screened for HTLV-I antibodies using the enzyme-linked immunosorbent assay and the results were confirmed by Western Blot. The presence of clinical features of Adult T-cell leukaemia/lymphoma (ATL) were assessed and compared between HTLV-I seropositive and HTLV-I seronegative groups. Seventy-three patients (65.8 percent) were HTLV-I seropositive and 38 were HTLV-I seronegative. Marked morphologic heterogeneity was noted within both groups. As expected, within the HTLV-I seropositive group many patients showed clinical features of ATL such as hypercalcaemia (37/73), leukaemia (29/73), bone marrow involvement (18/73), skin infiltration (28/73) and lytic bone lesions (4/73). Clinical features of ATL were also seen within the HTLV-I seronegative group. Fourteen patients (36.8 percent) showed two of the clinical features of ATL. Twelve (31.6 percent) showed one of the clinical features of ATL. It is possible that these patients may be HTLV-I seronegative and proviral DNA positive and should therefore be included in the ATL group. Further studies are necessary to confirm this. The remaining seronegative patients represent cases of T-cell lymphoma that are not associated with HTLV-I infection (AU)