Endoscopic assessment of adenoid size is an indicator of tissue virologic response to highly active antiretroviral therapy.
OBJECTIVE
To compare human immunodeficiency virus viral load (HIVVL) in plasma versus the adenoid HIVVL during highly active antiretroviral therapy (HAART).


METHODS
Adenoid biopsies were taken basally and after 3 and 6 months of treatment. Also, the adenoid diameter by simple endoscopy was measured, and its correlation with adenoid HIVVL was calculated.


METHODS
A public tertiary care human immunodeficiency virus (HIV) hospital research centre. Twenty-seven antiretroviral-naive HIV-infected patients, with a mean age of 34.7 years, were included in the study.


METHODS
Correlation between adenoid diameter and plasma and tissue HIVVL.


RESULTS
At 3 months, although plasma HIVVL reduced by almost 5 log to a level below 1 log, adenoid HIVVL only decreased 2.36 log, remaining well over 4 log. At 6 months, plasma HIVVL further decreased to 0.205 log, but adenoid HIVVL remained at 2.424 log. Adenoid diameter also decreased over time, with means at 8.52, 5.61, and 4 mm, respectively. It significantly correlated with plasma and adenoid viral load, but the correlation was higher with the biopsies.


CONCLUSIONS
HIVVL in adenoid tissue is more resilient to HAART than plasma VL and may need more than 6 months to reach asymptomatic levels. Nevertheless, simple endoscopic measurement of the adenoid diameter is a good indicator of viral load decrease in this tissue.
Center for Infectious Diseases Research, National Institute for Respiratory Diseases, México City, México.
Enrique
E
Espinosa
Luis
L
Velázquez-Villaseñor
Antonio
A
Soda-Merhy
Klintsy
K
Torres
Christopher E
CE
Ormsby
Gustavo
G
Reyes-Terán
D000234:Adenoids / Q000033:anatomy & histology* / Q000821:virology*; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D001706:Biopsy; D015153:Blotting, Western; D004724:Endoscopy; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy* / Q000821:virology*; D006801:Humans; D008214:Lymphocytes / Q000473:pathology; D008875:Middle Aged; D009929:Organ Size; D019562:Viral Load; D055815:Young Adult