The Diffuse Infiltrative Lymphocytosis Syndrome. Clinical and Immunogenetic Features in 35 Patients

AIDS. 1996 Apr;10(4):385-91.

Abstract

Objective: To study the epidemiological, clinical, serological and immunogenetic features of the diffuse infiltrative lymphocytosis syndrome (DILS).

Design: Consecutive series of 35 patients with DILS diagnosed from 1992 to 1995 in a cohort of 4100 outpatients infected with HIV-1.

Methods: Thirty-five individuals with DILS were ascertained from this cohort and followed for 720 patient-months. Clinical, serological and immunogenetic features of these patients were studied and their demographics were compared with the rest of the outpatient population.

Results: DILS was found to be more prevalent in African Americans (60%) than in Caucasians (26%) or Mexican Americans (14%) [odds ratio (OR), 2.32; 95% confidence interval (CI), 1-12-4.81; P = 0.02] and in persons with male-to-male transmission of HIV-1 (71%) (OR, 2.82; 95% CI, 1.29-6.29; P = 0.007). All patients had bilateral parotid gland enlargement. The majority had sicca symptoms. The most common extraglandular sites of disease were lung (31%), muscle (26%), and liver (23%). Four patients had biopsy-proven polymyositis. Thirteen patients met the 1993 Centers for Disease Control and Prevention case definition of AIDS. Sixteen (52%) patients expressed human leukocyte antigen (HLA)-DRS (DRB1*1102), DR6 (DRB1*1301, *1302), or DR7, and 11 (36%) expressed HLA-DR2.

Conclusions: DILS is more common in African Americans and in persons with male-to-male transmission of HIV-1. HIV-associated polymyositis appears to occur in the setting of DILS.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • African Continental Ancestry Group / genetics
  • Amino Acid Sequence
  • Anti-Inflammatory Agents / therapeutic use
  • Cohort Studies
  • Female
  • Genes, MHC Class II / genetics
  • HIV Infections / immunology*
  • HIV Infections / transmission
  • HIV-1*
  • Humans
  • Lymphocytosis* / complications
  • Lymphocytosis* / drug therapy
  • Lymphocytosis* / epidemiology
  • Lymphocytosis* / ethnology
  • Lymphocytosis* / immunology
  • Lymphocytosis* / physiopathology
  • Male
  • Middle Aged
  • Molecular Sequence Data
  • Parotid Gland / pathology
  • Polymyositis / etiology
  • Prednisone / therapeutic use
  • Prevalence
  • Salivary Gland Diseases
  • Salivary Glands, Minor / pathology
  • Syndrome

Substances

  • Anti-Inflammatory Agents
  • Prednisone