Tonsil hypertrophy. Enlarged tonsils of an HIV positive patient. Hypertrophy of the tonsils occurs in some patients in association with persistent generalised lymphadenopathy (swelling of the lymph nodes). Such symptoms reflect the progressive breakdown of immune competence associated with human immunodeficiency virus (HIV), the cause of acquired immune deficiency syndrome (AIDS). Tonsil hypertrophy is often more symmetrical than shown here. This image was taken in Africa, where lack of access to medicine and information makes AIDS a major public health concern.