title: Outpatient biopsies of the palatine tonsil: access to lymphoid tissue for assessment of human immunodeficiency virus RNA titers.
abstract: OBJECTIVE
  Our objective was to assess the feasibility of using tonsillar lymphoid biopsy specimens obtained on an outpatient basis to quantitate a patient's lymphoid human immunodeficiency virus (HIV) RNA titers.
  
  
  METHODS
  A pilot cohort study was performed.
  
  
  METHODS
  We evaluated ten HIV-seropositive patients who ranged in age from 26 to 48 years and had CD4+ cell counts ranging from 110 to 833 at enrollment.
  
  
  METHODS
  The main outcome measures were tolerance and safety of outpatient tonsil biopsies and quantitation of HIV RNA titers in tonsillar lymphoid biopsy specimens, plasma, and peripheral blood mononuclear cells determined by a new method of HIV RNA signal amplification with branched DNA probes.
  
  
  RESULTS
  Outpatient tonsil biopsies were well tolerated and were performed without complications. Nine of 10 tonsil biopsies from the HIV-seropositive patients examined were positive for significant concentrations of HIV RNA, ranging from 106 to 101 HIV RNA equivalents per gram of tissue. All of the HIV RNA-positive tonsillar lymphoid specimens had HIV RNA titers that were 101 to 104 times greater than those recovered from plasma (per milliliter) of the same patient obtained at the time of biopsy.
  
  
  CONCLUSIONS
  Sufficient tonsillar tissue can be obtained in an outpatient clinic setting to quantitate lymphoid HIV titers by the new branched-DNA signal amplification method with relative ease and without complication. The biopsy method described here affords ready access to the lymphoreticular system, which may help to advance our understanding of the pathogenesis of myriad immune diseases without the need for excisional node biopsies.
authors.affiliation: Department of Otolaryngology/Head and Neck Surgery, University of Minnesota Medical School, St. Paul, 55101, USA.
authors.forename: R A
authors.initials: RA
authors.lastname: Faust
authors.forename: K
authors.initials: K
authors.lastname: Henry
authors.forename: P
authors.initials: P
authors.lastname: Dailey
authors.forename: H
authors.initials: H
authors.lastname: Melroe
authors.forename: C
authors.initials: C
authors.lastname: Sullivan
authors.forename: A
authors.initials: A
authors.lastname: Erice
authors.forename: A T
authors.initials: AT
authors.lastname: Haase
authors.forename: L R
authors.initials: LR
authors.lastname: Boies
mesh_terms: D000328:Adult; D000554:Ambulatory Care Facilities; D000556:Ambulatory Surgical Procedures; D001706:Biopsy / Q000379:methods*; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D015342:DNA Probes; D005240:Feasibility Studies; D006679:HIV Seropositivity / Q000097:blood / Q000175:diagnosis* / Q000821:virology; D006801:Humans; D008875:Middle Aged; D009693:Nucleic Acid Hybridization; D015345:Oligonucleotide Probes; D014066:Palatine Tonsil / Q000473:pathology* / Q000821:virology*; D010865:Pilot Projects; D012367:RNA, Viral / Q000032:analysis*
chemical_list: D015342:DNA Probes; D015345:Oligonucleotide Probes; D012367:RNA, Viral