Hemophagocytic Syndrome in HIV-Infected Patients

Hemophagocytic syndrome (HS) is characterized by fever, lymphadenopathy, hepatosplenomegaly, cytopenias, and hyperferritinemia. Secondary, or reactive, HS can be triggered by malignancy, infection, or autoimmune disease. Although reactive HS (RHS) has been reported in HIV-infected patients, we have little information about the features of this disorder in the era of combination antiretroviral therapy (ART).

A retrospective review involving three tertiary care centers in France revealed 58 cases of RHS (43 certain; 15 possible) in HIV-infected patients during 2006 and 2007. At the time of RHS diagnosis, patients had a median CD4 count of 91 cells/mm³; 57% were receiving ART; 35% had an undetectable viral load. An underlying cause of RHS was d…