HIV-associated sialadenitis in a child: clinical case report

Relevance. Salivary gland involvement is a recognized clinical manifestation of HIV infection in children. The parotid glands are most commonly affected, although other major salivary glands may also be involved. Early recognition of these signs by dentists, oral and maxillofacial surgeons, and pediatricians can facilitate timely diagnosis of HIV infection and the initiation of antiretroviral therapy (ART) to prevent progression to AIDS. This article reviews current data on HIV-associated salivary gland disease in children and provides management recommendations based on a clinical case of HIV-associated sialadenitis. Clinical case description. A boy aged 10 years 10 months presented with bilateral neck swelling, weakness, and fatigue at N. F. Filatov Children’s City Clinical Hospital No. 5, St. Petersburg, Russia. Serological testing for HIV-1/2 antibodies and HIV-1 antigen (Form 50 report) was positive. Immunophenotyping showed CD4+ T-lymphocytes at 11 and the HIV-1 RNA viral load was 145,000 copies/mL. The child’s mother was also HIV-positive; her infection had been anonymously confirmed, but she had not previously sought medical care. Following evaluation, both mother and child were started on ART. The child was diagnosed with HIV infection (stage 4A, prior to ART), persistent generalized lymphadenopathy, thrombocytopenia, severe immunodeficiency, and HIV-associated sialadenitis. Under ART, clinical improvement was observed: the child became active, and the cervical swelling decreased. The patient remains under follow-up with a pediatrician and an infectious-disease specialist at the St. Petersburg Center for AIDS and Infectious Diseases and continues ART with good tolerability. Conclusion. Healthcare professionals should consider HIV-associated salivary gland disease in the differential diagnosis of children presenting with persistent or recurrent parotid swelling. Early initiation of ART, careful assessment of readiness for treatment, and parental support for adherence are crucial elements of management. Continued public health education on HIV transmission, prevention, and the role of ART in achieving viral suppression and improving quality and length of life remains essential.