title: Response of lymphoepithelial parotid cysts to antiretroviral treatment in HIV-infected adults.
abstract: BACKGROUND
  Surgical resection has been the usual therapy for HIV-infected patients with lymphoepithelial parotid cysts.
  
  
  OBJECTIVE
  To study antiretroviral therapy for lymphoepithelial parotid cysts.
  
  
  METHODS
  Case series.
  
  
  METHODS
  HIV outpatient clinics.
  
  
  METHODS
  HIV-infected patients with lymphoepithelial parotid cysts.
  
  
  METHODS
  Antiretroviral therapy.
  
  
  METHODS
  Change in size of the parotid cyst, CD4 lymphocyte count, and HIV viral load.
  
  
  RESULTS
  Nine HIV-infected adults presented with chronic, large parotid cysts, eight of which were bilateral. In at least seven patients, the cysts were the initial sign of HIV infection. In six patients, the cysts resolved completely with combination antiretroviral therapy. Four of these patients also received prednisone. Three patients who did not comply with antiretroviral therapy had partial responses followed by relapses.
  
  
  CONCLUSIONS
  Parotid cysts are an unrecognized sign of early HIV infection. These cysts respond to combination antiretroviral therapy, with or without corticosteroids. Surgical resection should be reserved for patients in whom medical therapy has failed or those who refuse or are poorly compliant with medical therapy.
authors.affiliation: Boston University School of Medicine, Boston Medical Center, Massachusetts 02118, USA.
authors.forename: D E
authors.initials: DE
authors.lastname: Craven
authors.forename: R A
authors.initials: RA
authors.lastname: Duncan
authors.forename: J R
authors.initials: JR
authors.lastname: Stram
authors.forename: C J
authors.initials: CJ
authors.lastname: O'Hara
authors.forename: K A
authors.initials: KA
authors.lastname: Steger
authors.forename: K
authors.initials: K
authors.lastname: Jhamb
authors.forename: L R
authors.initials: LR
authors.lastname: Hirschhorn
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D002908:Chronic Disease; D003560:Cysts / Q000188:drug therapy* / Q000473:pathology; D004359:Drug Therapy, Combination; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D007124:Immunoenzyme Techniques; D008297:Male; D008875:Middle Aged; D010305:Parotid Diseases / Q000188:drug therapy* / Q000473:pathology; D011241:Prednisone / Q000627:therapeutic use; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents; D005938:Glucocorticoids; D011241:Prednisone