The oropharynx, the middle part of the throat that includes the tonsils and the soft palate, can be a site of active HIV replication in patients with high viral loads and intact tonsils, according to a study in the July 1 edition of the Journal of Infectious Diseases. Researchers examined 63 HIV-positive men who have sex with men and discovered that 69% had detectable pharyngeal HIV RNA. Four of 14 men with both intact tonsils and high pharyngeal viral loads also carried replication-competent virus on the surface of their tonsils. Patients who had had their tonsils removed were less likely to shed HIV from the oropharynx, as was also the case for those regularly taking anti-HIV medications and those with high CD4-cell counts. The researchers theorize that the tonsils may serve as an HIV repository, both inside tonsil tissue and on the surface of the organs.
