title: Discovery of human immunodeficiency virus infection by immunohistochemistry on lymph node biopsies from patients with unexplained follicular hyperplasia.
abstract: Over the last 10 years, 240 cases of hyperplasic lymphadenitis have been systematically tested in our institution for the presence of the human immunodeficiency virus (HIV). This series comprised patients between 15 and 90 years (median of age: 38.51) without a past history of HIV infection. The technical approach consisted in an immunohistochemical procedure with a monoclonal antibody against the p24-gag protein of HIV. Among the 240 cases, 105 had a true follicular hyperplasia. Overall, this survey found that 4 cases (3 males and 1 female) were positive for p24-gag without previous knowledge of HIV infection (4/240=1.66%). HIV infection was further confirmed by serologic and molecular investigations in all cases. These results were seen exclusively in those cases with prominent follicular hyperplasia (4/105=3.80%). Staining with the anti-p24 antibody was intense and restricted to the follicular dendritic cell networks. In one case, beside hyperplasic germinal centers, one could see a regressed onion bulblike structure. One important conclusion can be drawn from this study. A systematic research of HIV proteins should be performed in all lymph node biopsies with marked follicular hyperplasia, in a context of polyadenopathy, fever, and general status alteration. Besides giving an accurate diagnosis, this approach may be helpful in cases of recent infection in which anti-p24 antibodies are not yet detectable in the serum.
authors: INSERM, U.563, Centre de Physiopathologie, de Toulouse-Purpan, CHU Purpan, F-31300 Toulouse, France.
authors: Geisilene Russano
authors: GR
authors: de Paiva
authors: Camille
authors: C
authors: Laurent
authors: Aurélie
authors: A
authors: Godel
authors: Nivaldo Adolfo
authors: NA
authors: da Silva
authors: Michel
authors: M
authors: March
authors: Georges
authors: G
authors: Delsol
authors: Pierre
authors: P
authors: Brousset
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D005260:Female; D006678:HIV / Q000276:immunology / Q000302:isolation & purification*; D016655:HIV Core Protein p24 / Q000032:analysis; D015658:HIV Infections / Q000175:diagnosis* / Q000821:virology; D006801:Humans; D007150:Immunohistochemistry; D008198:Lymph Nodes / Q000473:pathology* / Q000821:virology; D008297:Male; D008875:Middle Aged; D019310:Pseudolymphoma / Q000473:pathology* / Q000821:virology
chemical_list: D016655:HIV Core Protein p24