From the Guidelines
Recurrent adenoid hypertrophy is associated with Human Immunodeficiency Virus (HIV) infection, as HIV-infected individuals can experience persistent or recurrent enlargement of adenoid tissue due to lymphoid hyperplasia, a common manifestation of HIV infection. This relationship is supported by the fact that CRS or recurrent ARS can affect 30% to 68% of patients with HIV infection, as noted in the clinical practice guideline update on adult sinusitis 1. The guideline highlights that immunodeficiency, including HIV infection, should be considered in patients with CRS or recurrent ARS when aggressive management has failed or when sinusitis is associated with other infections such as otitis media, bronchiectasis, or pneumonia.
Key points to consider in the relationship between recurrent adenoid hypertrophy and HIV infection include:
- Lymphoid hyperplasia, a common manifestation of HIV infection, can cause persistent or recurrent enlargement of adenoid tissue
- HIV-infected individuals, especially those with advanced disease or poor viral control, are more likely to experience adenoidal hypertrophy
- Optimizing HIV treatment with antiretroviral therapy is essential for managing recurrent adenoidal problems
- Surgical intervention may be necessary in some cases, but addressing the underlying HIV infection is crucial for long-term management
The clinical practice guideline update on adult sinusitis 1 provides evidence that immunodeficiency, including HIV infection, is a significant factor in recurrent adenoid hypertrophy, and managing the underlying HIV infection is essential for reducing the risk of recurrent adenoidal problems.
From the Research
Relationship Between Recurrent Adenoid Hypertrophy and HIV Infection
- There is evidence to suggest a relationship between recurrent adenoid hypertrophy and HIV infection, as reported in a case study where adenoidal hypertrophy was the presenting feature of HIV infection in a haemophiliac child 2.
- A study examining the incidence of non-malignant nasopharyngeal lymphoid hyperplasia in HIV infection found that adenoidal width was greater in HIV-positive patients compared to healthy control subjects, with a mean adenoidal width of 6.76 mm in HIV-positive patients and 3.36 mm in control subjects 3.
- The study also found that age and HIV status correlated with nasopharyngeal width measurements, but no relationship was found between adenoidal width and hematocrit, CD4 count, or white blood cell count 3.
- Another study discussed the current literature on adenoid function, adenoidectomy indications, and treatment of adenoid hypertrophy, but did not specifically address the relationship between recurrent adenoid hypertrophy and HIV infection 4.
- Other studies have investigated the pathogenesis of adenoid hypertrophy, including the role of macrophages, neutrophils, and eosinophils in inflammation, as well as the use of non-surgical treatments such as intranasal corticosteroids 5, 6.