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Multicenter Study
. 2025 Sep 22;19(9):e0013558.
doi: 10.1371/journal.pntd.0013558. eCollection 2025 Sep.

Etiological spectrum and diagnostic features of lymphadenopathy in People Living with HIV in French Guiana: A 17-years multicenter retrospective case series

Morgane Bourne-Watrin  1 , Ugo Françoise  2   3   4 , Sophie Alexandra Baron  5 , Antoine A Adenis  2   3   4 , Dufens Pierre Louis  6 , Loïc Epelboin  2   7 , Mathieu Nacher  2   3   4 , Félix Djossou  7   8 , Kinan Drak Alsibai  4   9   10 , Pierre Couppié  1   8
Affiliations
Multicenter Study

Etiological spectrum and diagnostic features of lymphadenopathy in People Living with HIV in French Guiana: A 17-years multicenter retrospective case series

Morgane Bourne-Watrin et al. PLoS Negl Trop Dis. .

Abstract

Introduction: Lymph node enlargement can be present at any stage of the HIV infection, reactive to HIV itself, another infection, or a malignant source. The aim of our study was to describe the causes of lymphadenopathy in the people living with HIV (PLHIV) of French Guiana, a French territory in the Amazon region.

Methods: A retrospective multicenter case series was conducted between January 2005 and December 2021. Inclusion population consisted of PLHIV who underwent a fine needle aspiration or a biopsy of a lymph node that was analyzed at the Department of Pathology of Cayenne hospital.

Results: We included 152 adults, with a median age of 43 [35-51] years and median CD4 count of 185/mm3 [60-344]. The main causes of lymphadenopathy were: histoplasmosis (25%, CI95%: 18-33), followed by tuberculosis (24%, CI95%: 18-32), HIV-reactive lymphadenitis (21%, CI95%: 15-29) and lymphoproliferative disorder (11%, CI95%: 7-18). Multiple causes were present in 6% of cases. Opportunistic infections represented 53% (CI95%: 44-61) of cases. The main characteristics associated with opportunistic disease (infectious or neoplastic) were lymph node > 5 cm, CD4 count < 200/mm3, hepatomegaly or splenomegaly and the presence of extra-ganglionic symptoms.

Conclusion: For the last 17 years, opportunistic infections represented 53% of the causes of lymphadenopathy among PLHIV. Histoplasmosis, already recognized as the first AIDS-defining condition and first cause of AIDS-related deaths in French Guiana, is also the first cause of lymphadenopathy in PLHIV, ahead of tuberculosis and reactive lymphadenopathy. The CD4 count and the size of the lymph nodes appear to be the most important factors in the diagnostic process and should lead to a quick lymph node analysis in these patients.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow chart 2005-2021.
Abbreviations: FNA: Fine Needle Aspiration; LADP: Lymphadenopathy; PLHIV: People Living with the Human Immunodeficiency Virus.
Fig 2
Fig 2. Forest plot synthetizing the multivariate analysis of main abnormalities orienting to an opportunistic cause.
Fig 3
Fig 3. Boxplot of CD4 count according to whether the patient presented an opportunistic disease or not.
See this image and copyright information in PMC

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