Adenoidal tissue mass as a clinical guide of disease evolution in vertically HIV-1 infected children

Introduction: it is known that in early-stage HIV-induced disease there is a discrepancy between the levels of viral burden and virus replication in p eripheral blood versus lymphoid organs. HIV disease is active in the lympho id tissue throughout the period of clinical latency. However, it is not kno wn how long term progression of HIV infection is influenced by short-term c hanges in the adenoidal size. Objective: To assess the reliability of adeno idal-nasopharyngeal (AN) ratio in predicting clinical evolution of pediatri c HIV infection.:Methods: lateral radiographs of the nasopharynx in 94 Cauc asian children born to HIV-1-infected mothers ranged from 6 months to 15 ye ars (60 children infected with HIV-1 and 34 without HIV infection), and in a control group of 692 normal children were evaluated to obtain the AN rati o in order to identify the relationship of AN profiles with different stage s of the disease. Patients were rated regarding their clinical and immunolo gical status according to the Center for Disease Control Classification. Re sults: statistically significant differences between the groups of HIV-1-in fected children, seroreverters and controls in the AN ratio were found (P < 0.001). Moreover, significant differences were also found in individual ch ildren that correlated with clinical progression. Conclusion: examination o f radiographic changes in adenoidal size by AN ratio in relation to clinica l status during one year period in the whole group showed strong prognostic value. These findings may have important implications in the design of the rapeutic strategies. (C) 1999 Elsevier Science Ireland Ltd. All rights rese rved.