Objective. T h i s s tu dy ' s ai m w as to a s s e ss th e ef f e c t of h i gh l y a c ti v e an ti r e tr ov i r al d r u g s (HAART) on benign lymphoepithelial cysts (BLEC) of the parotid and ranulas.Study design. The records of 10 HIV-positive patients who presented with BLEC were reviewed, and 14 HIV-positive patients who presented with ranulas were prospectively enrolled. Patients in 2 both groups received the same combination of HAART and were clinically evaluated for the first three months. Patients with ranulas were followed up for an additional three months. A clinical reduction in the size of the lesions was considered to be a positive outcome.Results. All parotid glands with BLEC resolved within three months. No positive results were observed in ranulas during the first three months. However, some of the ranulas displayed a positive result after the initial three months of HAART. Conclusion.In contrast to BLEC, ranulas in HIV-positive patients seem to present a mixed and delayed response to HAART.Numerous publications report about HIV-related salivary gland disease (HIV-SGD). HIV-related enlargement of the parotid salivary gland, particularly benign lymphoepithelial cysts (BLEC), remains the most reported form of HIV-SGD. [1][2][3][4][5][6] Other salivary glands are affected as well 1 .However, little has been reported about ranulas as being part of HIV-related salivary gland Currently, the generally accepted standard mode of treatment for ranulas is surgical removal of the offending ipsilateral salivary gland either with or without the attached cystic lesion. [13][14][15] However, this radical surgical approach might face limitations in the current clinical presentations of some cases of ranulas in HIV-positive patients. Current cases seem to include more cases of plunging and bilateral ranulas (Fig. 1). More importantly, there are reported cases of BLEC co-existing with ranulas in the same subject and in multiple sites (Fig. 1A). This c l i n i c a l p r e s e n t a t i o n o f b o t h p a t h o l o g i e s i s o f g r e a t e t i o l o g i c a l i m p o r t a n c e a n d p r e s e n t s therapeutic implications in the context of HIV-SGD. The quest for a less invasive modality of 4 treatment for ranulas in HIV-positive patients might, therefore, become a greater challenge. To date, there is no evidence-based proof of treatment for ranulas with HAART. 12 The welldocumented benefit of HAART for BLEC in HIV-positive patients has led these authors to hypothesize that the very same drugs may positively affect ranulas in the context of HIV-SGD. A comparative approach has not been performed before.The aim of this study is, therefore, to assess how ranulas in HIV-positive patients respond to HAART, and compare the results with those of BLEC in parotid salivary glands in the context of HIV-SGD. Furthermore, a secondary objective is to define the time-frame within which to assess the effectiveness of the therapy in both groups. PATIENTS AND METHODSThis was a clinical study with both retrospective an...

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