Background: HIV can interrupt the normal development of bone marrow cell lines.
Bone marrow aspiration/biopsy (BMA/B) has been described as a diagnostic tool in AIDS patients
with fever of unknown origin (FUO). In this review, we aimed to study patients with AIDS who
had undergone a BMA/B to investigate FUO and describe the pathologies diagnosed in the biopsy.
Methods: Thirty-four BMA/B samples were collected from AIDS patients admitted for work-up of
FUO to the infectious disease ward of a tertiary referral HIV center in Tehran, Iran, between
September 2014 and September 2015. Data including age, sex, duration of disease, CD4 cell
counts, hepatitis B (HBV) and C (HCV) coinfection, the primary presentation of AIDS, and the
treatment history were retrieved and analyzed. Patients underwent BMA/B. An expert pathologist
reviewed the BMA/B specimens.
Results: The mean age of the patients was 37.5 years (range, 26-56), and 27 (79%) were men.
Twenty-seven (79%) patients contracted HIV from injection drug use, and 7 (21%) via sexual transmission.
Only 3 (9%) of the BMA/B examinations were normal. Hypocellular bone marrow was diagnosed
in 22 (65%) patients. Other pathologies included granulomas in 6 (18%), hematologic malignancies
in 2 (6%), and leishmaniasis Aspergillosis, each in 1 (3%) patient. Six (17%) of the specimens
were found to have tuberculosis infections.
Conclusion: Hypocellular bone marrow was the most common pathology on BMA/B examinations,
followed by the presence of granulomas. Tuberculosis, Aspergillosis, and Leishmaniasis the
opportunistic infections diagnosed on BMA/B specimens. Our results support BMA/B as an appropriate
diagnostic tool for early diagnosis of opportunistic infections and malignancies in AIDS.
BMA/B is indispensable in the armament of diagnostic tools of the physicians managing AIDS patients.