Variability of clinical, laboratory and instrumental manifestations of primary lymphoma of brain HIV-infected patients

Objective. The objective of this paper is to study variability of clinical, laboratory and instrumental manifestations of primary central nervous system lymphoma in HIV-positive patients. Materials and Methods. The authors conducted a retrospective analysis of medical records of 28 contagious patients with confirmed cases of HIV and brain lymphoma who received medical treatment at Central City Clinical Hospital in Ulyanovsk during 2007-2015. The majority of HIV-positive patients were males (82,7 %); only 17,3 % were females. The median age of patients enrolled in clinical trials was 34±3 years; 79,6 % of patients were aged between 17 to 45 years. HIV diagnosis verification was carried out according to V.I. Pokrovsky classification. General clinical studies were conducted using current standards. Assessment of disease severity, intensity of clinical manifestations, comorbidities and sequela was associated with Magnetic Resonance Imaging (MRI) results (number, size and localization of tumors), viral load levels, and CD4+ cells. Results and Discussion. Analysis of medical records of patients with AIDS-related brain lymphoma allowed us to identify variability of clinical, laboratory and instrumental manifestations of primary brain lymphoma in HIV-positive patients. The correlation between the level of immunosuppression and incidence of AIDS-related lymphoma in patients with advanced HIV/AIDS, opportunistic infections, high viral load and degree of immunosuppression was defined. Primary central nervous system lymphoma is considered to be the late manifestation of HIV infection. It is usually associated with Epstein-Barr virus (EBV). In our trial EBV was confirmed in 67 % of patients with brain lymphoma. Conclusions. Clinical manifestations of primary brain lymphoma depend on localization of tumors and opportunistic infections. Diagnosis of brain lymphoma is based on the results of MRI, spinal fluid test, viral load levels, and CD4+ cells.