悪性リンパ腫に対する化学療法後に発症したcytomegalovirus感染症を契機に判明した後天性免疫不全症候群

Acquired Immunodeficiency Syndrome with a Clinical Presentation of Cytomegalovirus Infection following Chemotherapy for Malignant Lymphoma

A 69-year-old deaf-mute man received 6 cycles of R-CHOP therapy for diffuse large B-cell lymphoma(DLBCL)of the stomach. Although he showed a complete response to this therapeutic regimen, the patient developed intractable diarrhea upon completion of chemotherapy. He was diagnosed with cytomegalovirus(CMV)enteritis and was administered ganciclovir and foscarnet;however, CMV infection persisted. We suspected immunodeficiency other than that associated with chemotherapy-induced immunosuppression. Further examinations revealed a decrease in the CD4^+ T lymphocyte count and positive results on anti-human immunodeficiency virus(HIV)antibody testing, which confirmed HIV infection, and he was diagnosed with acquired immunodeficiency syndrome(AIDS).Antiviral therapy was initiated, and the HIV-RNA viral load became undetectable;however, the CD4^+ T lymphocyte count recovery was insufficient. Despite the clinical presentation of an AIDS-indicator disease, diagnosis of HIV infection was delayed, which may be attributable to deaf-mutism and the patient’s advanced age that may have led to bias among the medical staff and prevented prompt diagnosis of HIV infection.

Creators Hamada Risako

Creators Sakai Kohei

Creators Konaka Kiminori

Creators Nakayama Ayana

Creators Nakano Kohei

Creators Matsumura Takuro

Creators Tominaga Takayuki

Creators Fujioka Yuka

Creators Takahashi Toru