The effect of antiretroviral therapy on fine needle aspiration of salivary gland masses in HIV-infected patients

Abstract

Background: South Africa has one of the highest prevalence rates of HIV/ AIDS. Salivary gland lesions are common in HIV- infected patients. The aim of this study was to determine the pathologic entities diagnosed on FNA of salivary gland masses in an HIV-infected study population that now has free access to ARVs and how this differs from the pathologic entities before the advent of widespread ARV availability. Methods A retrospective review was performed on confirmed HIV-infected patients who underwent FNA of salivary gland masses over a two year period. A computer generated search was conducted using the Cytopathology archives of the Cytopathology unit, Department of Anatomical Pathology, University of Witwatersrand and National Health Laboratory Service (NHLS), Johannesburg, South Africa from September 2014 to August 2016. The lesions were classified according to the Milan system for Reporting Salivary Gland Cytopathology. Results A total of 360 patients underwent FNA of salivary gland masses within the designated time frame, 58.3% females and 41.7% males. The parotid gland was the most biopsied salivary gland at 55.3%. The most common diagnosis made in patients on antiviral therapy was lymphoepithelial cyst and the most common diagnosis in patients not on antiviral therapy was infective (including abscess and mycobacterial infection). Common neoplasms sampled included non-Hodgkin lymphoma, pleomorphic adenoma and squamous cell carcinoma. Conclusion: Patients on antiretroviral therapy had higher CD4 counts, fewer infective lesions, and more reactive and benign lesions. Patients not on treatment had significantly lower CD4 counts and were frequently diagnosed with infective processes