CLINICAL-SIGNIFICANCE OF EOSINOPHILIA IN HIV-INFECTED INDIVIDUALS

PURPOSE: TO assess the clinical significance of peripheral eosinophili a in HIV-infected individuals. METHODS: In a retrospective case-contro l study we compared 42 HIV-infected patients (cases) with peripheral e osinophilia (absolute eosinophil count > 500 cells/mm(3)) with 84 HIV- infected controls without eosinophilia. Cases were matched to controls by date, and by CD4 cell count. Data on clinical parameters possibly associated with eosinophilia were collected and compared among cases a nd controls. RESULTS: Eosinophilia was seen in patients with late-stag e HIV disease (median CD4 cell count of 26 cells/mm(3)). Cases were mo re likely to be black (52% versus 18%, P = 0.0001), have pruritus (50% versus 20%, P = 0.002), and have a physician-documented rash (76% ver sus 52%, P = 0.02). Specific cutaneous diagnoses that were more preval ent in cases versus controls were eosinophilic folliculitis (24% versu s 1%, P = 0.0001), atopic dermatitis (14% versus 1%, P = 0.01), and pr urigo nodularis (7% versus O, P = 0.07). Other parameters commonly ass ociated with eosinophilia such as allergic reactions, parasitic infect ion, malignancy, and adrenal insufficiency were not found at higher in cidence in cases. CONCLUSIONS: Eosinophilia in AIDS patients is associ ated with cutaneous disease, but not with other conditions commonly as sociated with eosinophilia including parasitic infections, allergic re actions, or malignancy. Extensive work up for asymptomatic eosinophili a in patients with AIDS and cutaneous disease is not warranted. (C) 19 97 by Excerpta Medica, Inc.