Abdominal Lymphonodal Enlargement in HIV Patients Detected by Ultrasonography

We have read the article by Cassani et al. entitled “Abdominal Lymphoadenopathy Detected by Ultrasonography in HIV-I Infection: Prevalence and Significance” in Scand J Infect Dis 25: 221 -225, 1993 with interest and we would like to make some observations. Our studies aim to define the meaning of abdominal lymphadenopathy noticed by using Ultrasonography in HIV-I positive patients. We have tested 183 patients in various stages of HIV induced disease and have noticed the increased lymph nodes in 80 cases: group I comprised of 72 patients with lymphadenopathy in hepatoduodenal ligament only; group I1 (8 patients) had enlarged lymph nodes also in other abdominal stations. All patients, except 2, in group I and all the patients in group I1 demonstrated evidence of chronic hepatitis ( I ) or previous hepatitis B, C or D virus infection (2). Four patients from group I also had Non Hodgkin Lymphoma (3). Patients from group I1 had systemic CMV infection (4 pts), disseminated mycobacterium avium complex infection (2 pts) (4), disseminated Histoplasmosis ( 1 pt) (9, diseases which can cause lymphadenopathy also outside the hepatoduodenal ligament. Our results show that the most frequent cause of lymphadenopathy in the hepatoduodenal ligament in HIV patients is chronic hepatitis even if other diseases might cause lymphadenopathy (particularly lymphomas and opportunistic infections). Only in 2 patients with enlarged lymph nodes, who are followed up clinically, no other reasons for the lymphadenopathy besides HIV has been found. In conclusion, we believe that the finding of abdominal lymphonodal enlargement is not enough to include asymptomatic carriers (Class 11, CDC) (6) in group PGL (Class 111) unless previous contacts with hepatitis virus or other infectious agents or diseases able to cause such a change can be excluded.