Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology
Oral medicineComparative study of the effect of antiretroviral therapy on benign lymphoepithelial cyst of parotid glands and ranulas in HIV-positive patients
Section snippets
Patients and Methods
This was a clinical study with both retrospective and prospective components. It involved both pediatric and adult HIV-positive patients who presented with either an enlargement of the parotid glands or a ranula. In both components of the study, every patient acted as his/her own control. This reduced the effect of other confounding factors, such as age, gender, CD4+ cell count, and blood viral load.
Results
In Table I, the socioepidemiologic data and clinical results for the BLEC patients are summarized. In this retrospective study group, all 10 patients with BLEC displayed a positive result. The parotid gland swelling was completely reduced to a fraction of their initial size in 9 of the 10 patients. Figure 2 shows the initial and final clinical status of the enlarged parotid gland in one of the adult HIV-positive patients on HAART.
In the prospective study group (Table II), all of the 14 selected
Discussion
Enlargement of the parotid salivary glands, secondary to benign lymphoepithelial cysts, is the most described form of HIV-SGD. Not only is it a lesion frequently associated with HIV infection, but it is also a presumptive sign of a possible underlying HIV infection in both pediatric and adult patients. The prevalence of ranulas in HIV-positive patients is not well defined. In the specific context of the southern Africa region, where the prevalence of HIV infection is recognized to be
Conclusions
The retrospective component of this clinical study supports what has already been reported in the literature about the beneficial effect of HAART on HIV-related parotid cysts. The need for parotid gland surgery has been reduced, especially for patients who qualify for HAART.
The results observed in the prospective component of this study suggest, with caution, that HAART does not equally influence the course of ranulas in HIV-infected patients. One should be patient and first implement HAART
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Diagnostic discussionHIV associated salivary gland disease
Todays FDA
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Parotid lymphoepithelial cysts revealing HIV infection in a 12-year-old girl: A case report
2021, Annals of Medicine and SurgeryHuman immunodeficiency virus and salivary gland pathology: an update
2019, Oral Surgery, Oral Medicine, Oral Pathology and Oral RadiologyCitation Excerpt :HIV SGD occurs in all groups at risk for HIV infection—irrespective of mode of transmission, whether through heterosexual or homosexual acquisition—in people who inject drugs and in recipients of blood and blood products. Thus, there are conflicting reports regarding the prevalence of HIV SGD, with some studies showing a reduction in HIV SGD with HAART and others showing an overall increase in salivary gland pathology in the HAART era.17,18 This has been attributed to the size of pre-existing lesions; duration, time, and different regimens of HAART; and the inconsistent availability of HAART in developing countries.
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2014, Medical Clinics of North AmericaCitation Excerpt :Monitoring for the onset of a MALT lymphoma can be accomplished with periodic fine-needle aspiration biopsies. The introduction of highly active antiretroviral therapy (HAART) has resulted in effective reduction and control of the parotid swellings, and is sufficient to alleviate the cosmetic concerns of the patient.29 Unfortunately, collateral damage from HAART, in the form of metabolic disorders, is now recognized.
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2013, Diagnostic and Interventional ImagingThe potential impact of highly active antiretroviral therapy on the treatment and epidemiology of ranula in human immunodeficiency virus-positive patients
2013, Oral Surgery, Oral Medicine, Oral Pathology and Oral RadiologyCitation Excerpt :This study is based on the clinical observation, of 3 patients diagnosed HIV positive and presenting with ranula. These patients were initially part of a prospective study involving 14 HIV-positive patients.12 Based on the preliminary results of “positive change” observed in patients No. 7, 13 and 14 during the assessment term of between 3 and 6 months (Table I), it was decided to continue with the clinical observation of these subjects.
Benign Lymphoepithelial Cyst of Parotid Glands in HIV Infected Patients on Anti-Retroviral Therapy: A Narrative Review
2023, Indian Journal of Otolaryngology and Head and Neck Surgery