Sampling lymphoid tissue cells by ultrasound-guided fine needle aspirationof lymph nodes in HIV-infected patients

Objective: To establish the feasibility of using ultrasound-guided lymph no de needle aspiration as a means to obtain lymphoid tissue cells for the det ermination of a series of immunologic and virologic measures in HIV-infecte d patients. Design: First, a comparison of the characteristics of cell populations obta ined by simultaneous needle aspiration and standard excisional biopsy in si x patients. Second, use of lymph node needle aspiration to assess longitudi nally T-cell subset changes in patients initiating highly effective antiret roviral treatment. Methods: T-cell subsets (CD4 and CD8) and percentage Ki67+ cycling T cells were measured in lymph node cell populations harvested by ultrasound-guided aspiration or standard biopsy by Flow cytometry. Cellular RNA content was assessed by a modification of the Roche Amplicor HIV-1 Monitor test. Results: CD4 and CD8 T-cell percentage and HIV RNA cell content of lymph no de cell suspensions obtained from the simultaneous performance of ultrasoun d-guided needle aspiration and excisional biopsy in the same patients were correlated (n = 6). Among the 87 aspiration sessions reported here, mononuc lear cell suspensions were obtained in 100% of the sessions, in numbers ran ging between 4 x 10(4) to 6.7 x 10(6) cells (median: 7 x 10(5)). This limit ed number of cells did not allow to perform all type of analyses in all pat ients. By prioritizing the cells for the determination of T-cell subsets an d proliferation rate, this approach was instrumental For demonstrating the normalization of the T-cell subset ratio and the kinetic of normalization o f proliferating rates of CD4 and CD8 T cells, as well as the decrease in HI V-1 viral load in the lymph node following HAART initiation. Conclusion: Ultrasound-guided aspiration appears to be a non-invasive and a d libitum, safe and repeatable procedure for the longitudinal monitoring of changes in lymph nodes. (C) 1999 Lippincott Williams & Wilkins.