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Background: In recent years there has been a change in the opportunistic diseases incidence in HIV-infected patients. The change could be related to the use antiviral therapy and chemoprophylaxis strategies. The aim of the present study was to evaluate if medical intervention is able to modificate the clinical presentation of AIDS and the CD4+ lymphocyte counts at time of AIDS diagnosis., Patients and Methods: The first AIDS-defining condition and the CD4+ count at time of AIDS diagnosis were analyzed in 95 HIV-infected patients who developed an AIDS-defining disease since April 1989 until March 1996, retrospectively reviewed. Patients who had been previously followed at an AIDS Unit were compared with those who had not., Results: The frequency of Pneumocystis carinii pneumonia as the first AIDS-defining condition was lower in medically followed patients. Among this group, AIDS cases who received chemoprophylaxis with isoniazide showed a decrease in the rate of tuberculosis. No differences were found in CD4+ lymphocyte counts between both groups., Conclusions: As a result of medical intervention significant changes have occurred in the spectrum of initial AIDS-defining conditions in relation to medical intervention; a decrease in the frequency of Pneumocystis carinii pneumonia and tuberculosis have been found; however, the CD4+ lymphocyte counts at time of AIDS diagnosis are not modificated by medical intervention.

Cystic lymphoepithelial lesion is an infrequent disorder involving the saliva glands mainly the parotid gland; however, its frequency has increased coinciding with the epidemics of HIV-1 infection. Three cases of parotid lymphoepithelial lesion in patients with HIV-1 infection, 2 of whom were hemophiliacs and one an ex-intravenous drug addict, are presented. In all the cases the lesion was a painless slow growth right submandibular mass, with no history of inflammation. Two of the patients had a contralateral tumor of the same characteristics which was not studied. Fine needle aspiration puncture was performed in the three patients although diagnosis was obtained by pathologic study following superficial parotidectomy. Cystic lymphoepithelial lesion is an entity to be taken into account on differential diagnosis of cervical masses in patients with HIV infection. In individuals with severe immunosuppression treatment should be conservative.