This retrospective series of eight patients suggests that treatment with anti-TNF-alpha therapy is a viable alternative in HIV patients without advanced disease with associated rheumatic diseases refractory to standard therapy.

Objective. To describe the changing clinical spectrum of patients with diffuse infiltrative lymphocytosis syndrome (DILS) after the introduction of highly active antiretroviral treatment (HAART), and to carry out HLA class II oligotyping in these patients.

No abstract

Objective. To ascertain the prevalence of the diffuse infiltrative lymphocytosis syndrome (DILS) in human immunodeficiency virus type 1 (HIV-1)-positive outpatients.Methods. The presence of sicca symptoms and visible salivary gland enlargement was determined by interview and physical examination, and the clinical stage was determined by chart review, in 523 HIVpositive patients. The diagnosis of DILS was established in those with parotid gland enlargement by minor salivary gland biopsy or radionuclide scintigraphy.Results. Definite DILS was found in 15 (3%) of the 523 patients, and possible DILS in 18 (3.4%). The prevalence of definite DILS was significantly higher in African Americans (4.5%). Self-reported facial swelling and xerophthalmia that was not explained by the effects of medication were found more frequently in those with DILS than in the non-DILS patients. Patients with DILS had higher CD8 counts (mean +: SD 1,456 f 813/mm3) compared with those without DILS (934 +: 624/mm3; P < 1 X and were less advanced in their HIV clinical stage (Centers for Disease Control and Prevention stages A or B in 76% compared with 60% of the non-DILS group; P = 0.01).

Chronic medical conditions, particularly gastrointestinal disease, are risk factors for PBSIs. Because clinical illness may be more severe, alteration of the empiric antimicrobial regimen should be considered in some of these patients.