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infiltration. The most common site of involvement is the parotid gland, leading to bilateral facial
swelling and xerostomia. Less commonly involved are lung, muscle, and liver. Some patients
may also manifest either a peripheral neuropathy or polymyositis. The prevalence of DILS
appears to be decreasing with use of antiretroviral (ART) therapy.[580,581.582]
MULTIPLE MYELOMA.-- Although hypergammaglobulinemia is a common finding in
persons with AIDS, monoclonal gammopathy is not. Both transient and persistent
paraproteinemias have been observed in HIV-infected patients. The paraproteins have high-titer
anti-HIV activity. The same molecular mechanisms that give rise to non-Hodgkin lymphomas of
B-cell lineage can also give rise to myelomas, though the reduced T-cell function with HIV
infection may diminish the stimulus to plasma cell differentiation.[583] There is a 5-fold risk for
myeloma with AIDS (relative risk of 5).[560]
