Ultrasound characterization of superficial lymph nodes in HIV patients with lymphadenopathy

Background and aims HIV infection leads to immune deficiency and opportunistic infections, often presenting with lymphadenopathy. This study aims to characterize superficial lymph nodes in HIV patients using ultrasound and correlate these findings with T cell subset data to differentiate benign from malignant conditions. Methods A retrospective observational study was conducted on 149 HIV patients with lymphadenopathy from March 2016 to March 2024. Ultrasound examinations were performed, and pathological results were obtained through biopsy. Statistical analysis included univariate and multivariate logistic regression to identify predictors of malignancy. Results Ultrasound findings showed that malignant lymph nodes were larger, with a lower L/S ratio, absent hilum, and hypoechoic appearance. Immunological data revealed higher lymphocyte counts, T cell counts, and CD4 + T cell counts in the malignant group. The CD4 + T cell ratio was identified as an independent predictor of malignancy (OR 1.116, 95% CI 1.003–1.247, p = 0.043). Conclusion Ultrasound combined with T cell subset analysis may assists benign and malignant lymphadenopathy in HIV patients. The CD4 + T cell ratio is a significant predictor of malignancy.