Verlaufsbeobachtungen bei HIV-infizierten homosexuellen Männern mit Lymphadenopathiesyndrom

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Abstract
26 homosexual men with antibodies to HIV and generalized lymphadenopathy were examined between 1982 and 1984. Lymphadenopathy was accompanied by clinical symptoms such as fever, diarrhoea and weight loss (50%), moderate leukopenia (15%), lymphocytosis (50%), hypoergy to intraepidermal skin test with recall-antigens (12%), elevated serum levels of IgG (62%), IgA (23%), IgM (19%), beta-2-microglobulin (76%) and neopterin (69%), diminished absolute numbers of CD4-helper cells in the peripheral blood (24%) and an inversion of the ratio CD4-helper cells/CD8-suppressor cells both in blood (64%) and in lymphnodes (36%). Mitogen induced lymphocyte proliferation was significantly lower and the serum levels of gamma-interferon were significantly higher than in healthy controls. Lymphnode biopsy revealed only nonspecific reactive hyperplasia with follicular hyperplasia in 54%, a mixed pattern of both follicular hyperplasia and follicular involution with paracortical expansion in 25% and follicular involution with paracortical expansion in 21%. 22 patients were followed longitudinally for a median time of 37 months (33–51 months). 10 patients (46%) developed fullblown AIDS within a median period of 35 months (24–46 months) after first examination and 43 months (36–77 months) after the anamnestic onset of the lymphadenopathy syndrome. The parameters distinguishing these patients from those without progression of disease were higher serum levels of gamma-interferon, higher relative and absolute numbers of CD8-suppressor cells in the peripheral blood, a reduced number of CD4-helper cells in the lymphnodes, and a lower CD4/CD8 ratio as well in the peripheral blood as in the lymphnodes. Despite of the significant differences, these parameters varied in a wide range. Therefore, we could not establish a symptom likely to predict the emergence of AIDS in an individual patient.