AIDS and lymphadenopathy

AIDS and lymphadenopathyIt is now clear that infection with human T-lymphotropic virus I11 (HTLV-111) produces a clinical spectrum with the acquired immunodeficiency syndrome (AIDS) as only the most severe manifestation.Most of those infected are asymptomatic and healthy.Between AIDS and asymptomatic carriage lies a group of conditions intermediate in severity and frequency, the most common of which is an otherwise unexplained 'persistent generalized lymphadenopathy' (PGL)' -4.PGL may occur alone but when accompanied by other clinical and laboratory abnormalities it makes up an ill-defined package known as AIDS related complex (ARC).Clinical features include general malaise, fever, night sweats, weight loss, splenomegaly and minor opportunistic infections such as oral candidiasis and herpes zoster.Laboratory abnormalities include cytopenias (commonly lymphopenia), reduced numbers of Thelper cells which may give a reversed T-helper: T-suppressor ratio, raised ESR, polyclonal hypergammaglobulinaemia and skin anergy.How PGL fits into the natural history of HTLV-111 disease is uncertain.It may be an end-point in itself, from which recovery may occur, or it may be a prodrome of AIDS334.The percentage of patients with PGL who go on to develop AIDS has varied between 7 and 24 per cent over 40 months in different population^^*^.The presence of other S t .