Login Register Cart 0
Generic placeholder image

Infectious Disorders - Drug Targets

Editor-in-Chief

ISSN (Print): 1871-5265
ISSN (Online): 2212-3989

Back
Journal Home About Journal Editorial Board Journal Insight Current Issue Volumes/Issues
Subscribe
Research Article

Bone Marrow Aspiration/Biopsy in the Evaluation of Fever of Unknown Origin in Patients with AIDS

Author(s): Mahboubeh Hajiabdolbaghi, Bahar Ataeinia, Fatemeh Ghadimi, SeyedAhmad SeyedAlinaghi, Banafsheh Moradmand Badie, Omid Dadras* and Mehrnaz Rasoolinejad

Volume 21, Issue 3, 2021

Published on: 05 July, 2020

Page: [394 - 398] Pages: 5

DOI: 10.2174/1871526520666200705212903

Price: $65

Abstract

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.

Keywords: Bone Marrow Biopsy, AIDS, HIV, diagnosis, tuberculosis, aspergillosis.

Graphical Abstract

[1]
World Health Organization. Global health observatory (gho) data: Country statistics. Pridobljeno, 2018. Available from: http://www.who
[2]
HIV UG. Aids statistics—2018 fact sheet., 2019.
[3]
Sharifi, H.; Mirzazadeh, A.; Shokoohi, M. Estimation of HIV incidence and its trend in three key populations in Iran. PLoS One, 2018, 13(11), e0207681.
[http://dx.doi.org/10.1371/journal.pone.0207681] [PMID: 30496204]
[4]
Joulaei, H; Lankarani, KB; Kazerooni, PA; Marzban, M Number of hiv-infected cases in iran: True or just an iceberg. Indian journal of sexually transmitted diseases and AIDS, 2017, 38, 157.
[5]
Karamouzian, M.; Madani, N.; Doroudi, F.; Haghdoost, A.A. Improving the quality and quantity of hiv data in the middle east and north africa: Key challenges and ways forward. Int. J. Health Policy Manag., 2017, 6(2), 65-69.
[http://dx.doi.org/10.15171/ijhpm.2016.112] [PMID: 28812781]
[6]
Brook, M.G.; Ayles, H.; Harrison, C.; Rowntree, C.; Miller, R.F. Diagnostic utility of bone marrow sampling in HIV positive patients. Genitourin. Med., 1997, 73(2), 117-121.
[http://dx.doi.org/10.1136/sti.73.2.117] [PMID: 9215093]
[7]
Garhyan, J.; Bhuyan, S.; Pulu, I.; Kalita, D.; Das, B.; Bhatnagar, R. Preclinical and clinical evidence of mycobacterium tuberculosis persistence in the hypoxic niche of bone marrow mesenchymal stem cells after therapy. Am. J. Pathol., 2015, 185(7), 1924-1934.
[http://dx.doi.org/10.1016/j.ajpath.2015.03.028] [PMID: 26066709]
[8]
Karstaedt, A.S.; Pantanowitz, L.; Omar, T.; Sonnendecker, H.E.; Patel, M. The utility of bone-marrow examination in HIV-infected adults in South Africa. QJM, 2001, 94(2), 101-105.
[http://dx.doi.org/10.1093/qjmed/94.2.101] [PMID: 11181986]
[9]
Santos, E.S.; Raez, L.E.; Eckardt, P.; DeCesare, T.; Whitcomb, C.C.; Byrne, G.E., Jr The utility of a bone marrow biopsy in diagnosing the source of fever of unknown origin in patients with AIDS. J. Acquir. Immune Defic. Syndr., 2004, 37(5), 1599-1603.
[http://dx.doi.org/10.1097/00126334-200412150-00012] [PMID: 15577416]
[10]
World Health Organization. WHO case definitions of HIV for surveillance and revised clinical staging and immunological classification of hiv-related disease in adults and children., 2007.
[11]
Thiele, J.; Kvasnicka, H.M.; Facchetti, F.; Franco, V.; van der Walt, J.; Orazi, A. European consensus on grading bone marrow fibrosis and assessment of cellularity. Haematologica, 2005, 90(8), 1128-1132.
[PMID: 16079113]
[12]
Akpek, G.; Lee, S.M.; Gagnon, D.R.; Cooley, T.P.; Wright, D.G. Bone marrow aspiration, biopsy, and culture in the evaluation of HIV-infected patients for invasive mycobacteria and histoplasma infections. Am. J. Hematol., 2001, 67(2), 100-106.
[http://dx.doi.org/10.1002/ajh.1086] [PMID: 11343381]
[13]
Kyeyune, R.; Saathoff, E.; Ezeamama, A.E.; Löscher, T.; Fawzi, W.; Guwatudde, D. Prevalence and correlates of cytopenias in HIV-infected adults initiating highly active antiretroviral therapy in Uganda. BMC Infect. Dis., 2014, 14, 496.
[http://dx.doi.org/10.1186/1471-2334-14-496] [PMID: 25209550]
[14]
Dias, N.F.; Juliano, G.R.; Espindula, A.P.; de Oliveira, F.A.; Oliveira, L.F.; Cavellani, C.L.; Ramalho, L.S.; Teixeira, Vde.P.; Ferraz, M.L. Influence of AIDS in collagen deposition and thickness of the bone marrow. Ann. Diagn. Pathol., 2015, 19(6), 409-413.
[http://dx.doi.org/10.1016/j.anndiagpath.2015.10.003] [PMID: 26572847]
[15]
Tanaka, P.Y.; Hadad, D.J.; Barletti, S.C.; de Souza, S.A.; Calore, E.E. Bone marrow biopsy in the diagnoses of infectious and non-infectious causes in patients with advanced HIV infection. J. Infect., 2007, 54(4), 362-366.
[http://dx.doi.org/10.1016/j.jinf.2006.06.007] [PMID: 16875738]
[16]
Diebold, J.; Molina, T.; Camilleri-Broët, S.; Le Tourneau, A.; Audouin, J. Bone marrow manifestations of infections and systemic diseases observed in bone marrow trephine biopsy review. Histopathology, 2000, 37(3), 199-211.
[http://dx.doi.org/10.1046/j.1365-2559.2000.00965.x] [PMID: 10971695]
[17]
Paltrinieri, S.; Gradoni, L.; Roura, X.; Zatelli, A.; Zini, E. Laboratory tests for diagnosing and monitoring canine leishmaniasis. Vet. Clin. Pathol., 2016, 45(4), 552-578.
[http://dx.doi.org/10.1111/vcp.12413] [PMID: 27805725]
[18]
Quesada, A.E.; Tholpady, A.; Wanger, A.; Nguyen, A.N.; Chen, L. Utility of bone marrow examination for workup of fever of unknown origin in patients with HIV/AIDS. J. Clin. Pathol., 2015, 68(3), 241-245.
[http://dx.doi.org/10.1136/jclinpath-2014-202715] [PMID: 25589792]
[19]
Majedeh, Moradbeigi; SeyedAhmad, SeyedAlinaghi; Mansour, sajadipour; Omid, Dadras; Esfandiar, Shojaei; Parisa, Ahmadi; Saeed, Bayanolhagh; Kazem, Baesi*; and Mehrnaz, Rasoolinejad. The Relationship Between HIV Antibody Titer, HIV Viral Load, HIV p24 Antigen, and CD4 T-cell Count Among Iranian HIV-positive Patients. Infect. Disord. Drug Targets., 2020, 20(5), 752-757.

Rights & Permissions Print Cite
Article Metrics
18
1
© 2024 Bentham Science Publishers | Privacy Policy