Diagnostic utility of bone marrow sampling in HIV-infected patients since the advent of highly active antiretroviral therapy

M. J. Llewelyn, M. Noursedeghi, A. Dogan, S. G. Edwards, R. F. Miller

Research output: Contribution to journalArticle

7 Scopus citations

Abstract

We investigated the diagnostic value of bone marrow (BM) sampling in investigation of HIV-infected patients presenting to a major London HIV treatment centre between 1999 and 2004. One hundred and fourteen consecutive patients underwent 130 BM samplings. The majority of BM aspirates were normal or showed non-diagnostic changes; microscopy revealed lymphoma in one and mycobacterial infection in two. Subsequent culture identified mycobacterial infection in nine samples. BM trephine had a diagnostic yield of 26% in patients with fever and cytopaenia (including mycobacteriosis in 14%, lymphoma in 6%, Castleman disease in 3% and 'drug effect' in 3%), a yield of 20% in patients with fever, but no cytopaenia (mycobacteriosis in each case), and a yield of 19% in patients with cytopaenia in the absence of fever (lymphoma in 5% and 'drug effect' in 14%). In investigation/staging of lymphoma, the diagnostic yield was 36%. The overall yield from BM sampling was 30% in patients receiving highly active antiretroviral therapy (HAART) and 23% in those not receiving HAART. In this study, BM sampling was of most diagnostic value in HIV-infected patients where fever and cytopaenia coexisted in the absence of localizing signs of infection, and in the staging/investigation of lymphoma. BM sampling had less diagnostic value in the investigation of fever without cytopaenia or cytopaenia without fever.

Original languageEnglish (US)
Pages (from-to)686-690
Number of pages5
JournalInternational Journal of STD and AIDS
Volume16
Issue number10
DOIs
StatePublished - Oct 1 2005

Keywords

  • Bone marrow
  • HIV
  • Lymphoma
  • Mycobacteria
  • Pyrexia of undetermined origin

ASJC Scopus subject areas

  • Dermatology
  • Public Health, Environmental and Occupational Health
  • Pharmacology (medical)
  • Infectious Diseases

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