Human immunodeficiency virus lymph nodes

In a biopsy of an AIDS patient s enlarged thymus (P4), the adipose involuted thymus, with persistence of many Hassall s corpuscles, was judged to be a large lymphoid follicular hyperplasia. This follicular hyperplasia was similar to that described for lymph nodes, spleen, and other lymphoid tissues at earlier stages of human immunodeficiency virus infection, before the development of acquired immune deficiency syndrome. Human immunodeficiency virus RNA and p 24 were detected in the hyperplastic germinal centers (lymphocytes and follicular dendritic infected cells) and also in many cells that may have been either lymphocytes or epithelial cells in the interfollicular areas. 

Schmidtmayerova H, Nottet HS, Nuovo G, et al. Human immunodeficiency virus type 1 infection alters chemokine P peptide expression in human monocytes implications for recruitment of leukocytes into bram and lymph nodes. Proc Natl Acad Sci USA 1996 93 700-4. 

Infection with the human immunodeficiency virus (HIV) may produce isolated lymphadenopathy resulting from direct infection by the virus or from secondary infection (Radin 1995 Tarantino et al. 2003). Mesenteric lymphadenopathy in patients with HIV is far more likely to result from an opportunistic infection or even an underlying malignancy than to be caused by direct HIV infection. In this case, the lymph nodes may be enlarged but rarely massive. On the contrary, in HIV positive patients with a CD4 cell count of 50/mL or less, Mycobacterium avium complex (MAC) is the main cause of massive mesenteric lymphadenopathy. In HIV patients with mesenteric lymph nodes, in particular if forming a conglomerate mass, MAC infection should always be considered (Koh et al. 2003 Tarantino et al. 2003) (Fig. 2.9). 

HIV has been isolated in the blood, lymph nodes, brain, breast milk, semen, vaginal secretions, cerebrospinal fluid, saliva, tears, pericardial fluid, pleural fluid, synovial fluid and amniotic fluid of patients. However, its transmission has only been proven in the case of blood, semen, vaginal secretions and breast milk (Brasil, 1994). Thus the risk of contracting the Human Immunodeficiency Virus (HIV) among practitioners of dentistry is extremely low (CDC, 2003). 

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