Molokomme Thobile, Maharaj Shivesh, Motakef Shahpar
School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Indian J Otolaryngol Head Neck Surg. 2024 Aug;76(4):3289-3297. doi: 10.1007/s12070-024-04674-z. Epub 2024 Apr 10.
Nasal polyposis (NP) represents a benign proliferation of soft tissue tumors within the nasal cavity and paranasal sinuses, characterized by chronic inflammation of the sinonasal mucosa. This phenomenon, attributed to various environmental and physiological factors, presents clinically as semi-transparent masses with variable morphology, often obstructing nasal passages and causing respiratory compromise, olfactory dysfunction, and recurrent infections. Predominantly associated with chronic rhinosinusitis (CRS), NP poses significant challenges in diagnosis and management, particularly in the context of comorbid conditions such as human immunodeficiency virus (HIV) infection. HIV infection, known for its debilitating effects on the immune system, is theorized to exacerbate NP development and manifestation through mechanisms involving CD4 cell depletion and dysregulation of immune responses. Despite extensive research, elucidating potential pathways linking HIV infection to NP, comprehensive understanding remains elusive. This study aims to address this knowledge gap by conducting a retrospective chart review of patients presenting with NP at Charlotte Maxeke Johannesburg Academic Hospital between January 2016 and December 2020. The primary objective is to investigate the influence of HIV status on the clinical, radiological, and histological features of NP. Data collection, encompassing patient demographics, HIV status, clinical presentations, radiological findings, and histopathological characteristics, will be conducted between March 2021 and August 2022. Preliminary analysis of collected data reveals a cohort of 41 patients meeting inclusion criteria, with notable exclusions based on undisclosed HIV status and incomplete documentation. Initial findings suggest a nuanced interplay between genetic predisposition, environmental factors, and HIV status in NP pathogenesis, underscoring the need for further research to validate these observations. In conclusion, this study underscores the importance of elucidating the complex relationship between HIV infection and NP to optimize diagnostic and therapeutic approaches, particularly in regions with a high HIV prevalence such as South Africa. By comprehensively assessing the clinical, radiological, and histological features of NP in HIV-positive and HIV-negative populations, this research endeavours to enhance our understanding of NP pathophysiology and improve patient outcomes.
鼻息肉病(NP)是鼻腔和鼻窦内软组织肿瘤的良性增殖,其特征为鼻窦黏膜的慢性炎症。这种现象归因于多种环境和生理因素,临床上表现为形态各异的半透明肿物,常阻塞鼻道,导致呼吸不畅、嗅觉功能障碍和反复感染。NP主要与慢性鼻窦炎(CRS)相关,在诊断和治疗方面面临重大挑战,尤其是在合并人类免疫缺陷病毒(HIV)感染等共病的情况下。HIV感染以其对免疫系统的损害作用而闻名,理论上通过涉及CD4细胞耗竭和免疫反应失调的机制加剧NP的发展和表现。尽管进行了广泛研究,但阐明HIV感染与NP之间的潜在途径仍缺乏全面了解。本研究旨在通过对2016年1月至2020年12月在夏洛特·马克西克·约翰内斯堡学术医院就诊的NP患者进行回顾性病历审查来填补这一知识空白。主要目的是调查HIV状态对NP的临床、放射学和组织学特征的影响。数据收集将在2021年3月至2022年8月进行,包括患者人口统计学、HIV状态、临床表现、放射学检查结果和组织病理学特征。对收集到的数据进行的初步分析显示,有41名患者符合纳入标准,但因未披露HIV状态和记录不完整而有明显排除。初步研究结果表明,在NP发病机制中,遗传易感性、环境因素和HIV状态之间存在细微的相互作用,这突出了进一步研究以验证这些观察结果的必要性。总之,本研究强调了阐明HIV感染与NP之间复杂关系以优化诊断和治疗方法的重要性,特别是在南非等HIV感染率高的地区。通过全面评估HIV阳性和HIV阴性人群中NP的临床、放射学和组织学特征,本研究致力于增进我们对NP病理生理学的理解并改善患者预后。