Rosso Raffaella, Pretolesi Fabio, del Bono Valerio, Buscaglia Michele, Ferrando Sara, Farinella Sara Tita, di Biagio Antonio, Bassetti Matteo, Derchi Lorenzo E, Viscoli Claudio
Department of Infectious Diseases, DICMI, University of Genoa, San Martino Hospital, Genoa, Italy.
AIDS Patient Care STDS. 2006 Aug;20(8):536-41. doi: 10.1089/apc.2006.20.536.
Benign lymphoepithelial parotid lesions (BLL) are frequently reported in HIV-infected patients, although their clinical and prognostic significance in HIV infection has not been clearly defined. Ultrasonography (USG) has been shown to be a reliable method in monitoring the progression of such lesions. The purpose of this study was to describe the spectrum of sonographic and Doppler findings and to monitor any clinically evident physical change of parotid glands in a cohort of congenitally HIV-infected patients taking antiretroviral therapy. USG findings-based on their severity-have been grouped in three different patterns (0, 1, 2). Our cohort consisted of 51 patients with HIV in various Centers for Disease Control (CDC) stages and being given different antiretroviral protocols. The median USG follow-up was 36 months. The most frequent USG pattern was aspecific parotid gland enlargement (type 0, 45,1%). Patients with either lower CD4+ % (p < 0.20) and higher absolute and percent CD8+ cell count (p < 0.001 and p < 0.003) presented more frequently a type 2 USG pattern. None of them had any symptoms ascribed to "sicca syndrome" and only one patient developed non-Hodgkin's lymphoma during the follow-up, although his USG pattern at baseline was type 0. In summary, the spectrum of USG findings of BLL in vertically HIV-infected patients is broad. Because of the reported, although rare, possible malignant transformation of BLL in HIV-infected children, it is advisable to perform-even in asymptomatic patients-USG at least once per year or in concomitance with any physical modification of the parotid lesions.
良性淋巴上皮性腮腺病变（BLL）在HIV感染患者中经常被报道，尽管其在HIV感染中的临床和预后意义尚未明确界定。超声检查（USG）已被证明是监测此类病变进展的可靠方法。本研究的目的是描述先天性HIV感染患者队列中腮腺的超声和多普勒检查结果范围，并监测腮腺任何临床上明显的物理变化，这些患者正在接受抗逆转录病毒治疗。基于严重程度的USG检查结果已分为三种不同模式（0、1、2）。我们的队列由51名处于不同疾病控制中心（CDC）阶段且接受不同抗逆转录病毒方案的HIV患者组成。USG的中位随访时间为36个月。最常见的USG模式是腮腺非特异性肿大（0型，45.1%）。CD4+%较低（p<0.20）以及绝对CD8+细胞计数和CD8+细胞百分比较高（p<0.001和p<0.003）的患者更常出现2型USG模式。他们中没有人有任何归因于“干燥综合征”的症状，并且在随访期间只有一名患者发展为非霍奇金淋巴瘤，尽管他基线时的USG模式为0型。总之，垂直感染HIV患者中BLL的USG检查结果范围很广。鉴于有报道称，尽管罕见，但HIV感染儿童的BLL可能发生恶性转化，因此即使是无症状患者，建议每年至少进行一次USG检查，或者在腮腺病变有任何物理变化时进行检查。
