Peritonsillar abscesses in HIV positive patients
Friedland, Peter Leon
HIV positivity rates are high in South Africa. By August 1996 som e 2,5 million individuals were estimated to be positive. (21) At least 70% o f such HIV positive individuals present with head and neck manifestations, which include infection,inflammation and tumour, which are often the only and initial presenting sign. There has been no documented study detailing association between HIV positivity and peritonsillar abscesses. The aim of this study was to investigate the immune status and H IV seropositivity in a series o f patients with peritonsillar abscesses. The study sample consisted of all individuals with peritonsillar abscesses who presented to 5 academ ic hospitals in the Johannesburg/Soweto metropolitan complex over 7 months, and who gave informed consent to participate and have their HIV status measured. In the study period 96 patients, aged 20 to 49 years presented with peritonsillar abscesses, 57 of whom fulfilled the inclusion criteria. The clinical signs were recorded, as well as HIV status, CD4 and CD8 lymphocyte counts. The data were analysed using SAS. Ten of the 57 (18%) were HIV positive. Mean ( SD ) CD4 counts were HIV positive 0,448(0 ,124 ), HIV negative 0,899 (0,134); while CD8 results were HIV positive 0,865 (0,546 ), and HIV negative 0,546(0,250). General linear models analysis showed statistically significant effects o f HIV status on the CD4 ( P> 0 ,0001) and CD8 counts (P>0,01). Clinically all patients had similar presentations All showed no clinical signs of HIV disease and all were unaware of their HIV status. The HIV positive rate in the study sample (18%) was higher than the HIV positive rate in the general heterosexual South African population (12% ) for this region at the time of the study. This small sample of HIV patients suggests that peritonsillar abscess may be an early presenting sign o f HIV infection.