Page 245 - SAHCS HIVMed Journal Vol 20 No 1 2019

Southern African Journal of HIV Medicine
ISSN: (Online) 2078-6751, (Print) 1608-9693
Page 1 of 5 Original Research

Tonsil histopathology in HIV-infected

versus HIV-uninfected adults

Authors: Background: The relationship between HIV and tonsil malignancy has not been
Ridwaan Essa fully investigated and established. Both of these diseases prominently feature in the
1
1
Shivesh Maharaj
Kapila Hari Otorhinolaryngology clinics.
2
Shahpar Motakef
1
Objective: There is minimal data available on the histopathology of tonsillectomy specimens
Affiliations: in the HIV-infected population. This retrospective review compared tonsil histopathology
1 Department of between HIV-infected and HIV-uninfected patients.
Otorhinolaryngology,
University of the Methods: Of the 319 adult patients undergoing tonsillectomy (01 July 2005 to 30 June 2015),
Witwatersrand, Johannesburg, HIV results were available for 160. The histological findings were compared in the HIV-
South Africa infected and HIV-uninfected subgroups. The effects of age, HIV status and CD4 count on the
risk of malignancy were determined.
2 Department of Internal
Medicine, Faculty of Results: There were 86 patients who were HIV-infected and 74 were uninfected. Reactive
Health Sciences, University
of the Witwatersrand, lymphoid hyperplasia was the most common diagnosis in both groups (77%). Malignancies
Johannesburg, South Africa were diagnosed in eight HIV-infected and six HIV-uninfected patients, an insignificant
difference.
Corresponding author:
Shivesh Maharaj, Conclusion: The majority of patients undergoing tonsillectomy had benign conditions. HIV
[email protected] status does not appear to be a specific risk factor for tonsil malignancies, but advanced age
may be.
Dates:
Received: 29 Nov. 2018 Keywords: HIV; Malignancy; Tonsil; Tonsillectomy; HIV-infected patients; HIV-uninfected
Accepted: 26 Feb. 2019
Published: 28 May 2019 patients.

How to cite this article:
Essa R, Maharaj S, Hari K, Introduction
Motakef S. Tonsil
histopathology in HIV- In resource-rich centres, histopathology assessments are performed routinely on adult
infected versus HIV- tonsillectomy specimens. The merits of routine tonsillar histopathology in poorly resourced
1
uninfected adults. S Afr J HIV centres have been questioned. A recent systematic review by Rokkjaer et al. (12 studies including
2
Med. 2019;20(1), a936.
https://doi.org/10.4102/ 6434 patients) concluded that there is inadequate proof for routine histological examinations from
sajhivmed.v20i1.936 patients who do not exhibit high-risk features. 3
Copyright: Beaty et al. in 1998 identified certain features that were associated with an increased risk of
© 2019. The Authors.
Licensee: AOSIS. This work tonsillar malignancy:
is licensed under the • History of cancer.
Creative Commons
Attribution License. • Tonsillar asymmetry.
• Tonsil firmness.
• Visible lesions.
• Concomitant neck adenopathy.
• Unexpected weight loss.
• Constitutional symptoms (fatigue, night sweats, fever, anorexia). 4

Recent evidence suggests that HIV infection should be considered an additional risk factor for
1
malignancy. In view of the limited data in our setting, especially in the adult population where
the prevalence of HIV infection is high (18% in the adult population), we set out to determine
5
whether tonsillar histological studies differed between the HIV-infected and HIV-uninfected
patients.
Read online:
Read online:
Scan this QR Few studies have documented the effect of HIV infection on tonsillar histology. One Nigerian
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code with your study by Adoga et al. reviewed 61 patients. The cohort comprised 35 children and 26 adults. They
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smart phone or
smart phone or
mobile device
mobile device did not comment on the number of patients with HIV infection, although they did detect
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to read online.
lymphoma in an adult patient with HIV. They concluded that a request for histopathology on
http://www.sajhivmed.org.za 238 Open Access