HIV-associated salivary gland disease

Parotid enlargement (a.k.a parotidomegaly) has a wide differentials. Causes include inflammatory, infective, Immune, neoplastic, infiltrative, and congenital causes.

Epidemiology

HIV-SGD have been reported to be 48% in developing territories ³

Clinical presentation

HIV related disease generally presents with dry mouth with swelling of the major salivary glands.

Clinical presentation

Victims frequently present with signs of facial swelling, fever, myalgias, dry mouth and myalgiasswelling of salivary glands

Pathology

BK viral shedding in the sputumIn a consequence of HIV infection, lymphoid infiltration in to gland, along with lymphoid epithelial lesions development are main causes of salivary gland disease patients consistent with viral infectionenlargement and replication, suggesting a role for oral transmissionxerostomia ⁴

Histology

Benign lymphoepithelial/myoepithelial lesion comprising of an intranodal cysts lined with epithelial cells

Radiological features

Radiological features are non specific

US

•  Numerous hypoattenuating / anechoic regions without posterior acoustic enhancement
• Anechoic cysts²

MR/CT 

• Parotid enlargement bilaterally with intraglandular cystic and solid masses
•  Increase in size and number of cervical lymph nodes ²

Treatment and prognosis

ART was useful in treatment of lymphoepithelial parotid cysts ⁴. In children there is a good prognosis reported ²

 HIVHIV influence salivary gland disease was first used by shiodt to characterize a swelling of major salivary glands with a complaint of dry mouth in the deficiency of xerogenic agents ^4 3