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A study in the July 1 edition of the Journal of Infectious Diseases shows that 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, HIVandhepatitis.com reports. The study, conducted among HIV-positive men in the United States and Peru, showed that the men being treated with anti-HIV drugs as well as untreated men who had their tonsils removed had lower pharyngeal HIV viral loads than untreated men who still had their tonsils. HIV also was found on the surface of the tonsils in four of 14 men who had intact tonsils and high viral loads. The researchers conclude that antiretroviral therapy and having had one's tonsils removed were the strongest predictors of low pharyngeal HIV viral loads in HIV-positive people and that high viral loads could result in HIV replication in the tonsils. Although HIV is rarely detected in the saliva, it is possible that the presence of HIV in the tonsils could account for those cases where the virus has been detected in oral fluids.
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