A study on otorhinolaryngologic manifestations in human immunodeficiency virus infected patients
Keywords:HIV, AIDS, Oral hairy leukoplakia, Kaposi sarcoma, Oral candidiasis, Tubercular laryngitis
Background: The main aim of this study was to find out the ear, nose, and throat (ENT) manifestations in a selected regional population of 100 HIV infected patients, to identify the commoner ENT manifestations among them and to make these manifestations, a guide for regional ENT surgeons, to diagnose HIV/AIDS patients early and to treat them accordingly.
Methods: The study was a prospective study which was conducted for a period of five years which included 100 HIV seropositive patients, among the patients attending the Outpatient Department of the Otorhinolaryngology and anti-retroviral therapy centre across Government Hospitals in Tamil Nadu according to our inclusion or exclusion criteria. Detailed ENT clinical examination as well as laboratory investigations were carried out to evaluate the nature of ENT presentations of HIV infection.
Results: Out of the 100 HIV positive patients, who had some form of ENT symptoms, the most common ENT manifestation in HIV/AIDS was oral candidiasis (40%) followed by cervical lymphadenopathy (30%). Other common manifestations are oral herpes simplex and sensorineural hearing loss. Less common manifestations are chronic sinusitis, tuberculous laryngitis, chronic otitis media, oral hairy leukoplakia, nasal polyps and Kaposi’s sarcoma. Oral candidiasis, chronic/recurrent mucocutaneous herpes simplex, oral hairy leukoplakia and Kaposi’s sarcoma are the AIDS defining illnesses. Oral hairy leukoplakia, is pathognomonic of HIV infection.
Conclusions: These manifestations help ENT surgeons, to recognize HIV/AIDS patients from the specific ENT lesions occurring in them, for early diagnosis and subsequent treatment.
Hillel A, O’Mara W, Nemechek A, Mushatt DM. Head and neck manifestations in HIV infection. J La State Med Soc Off Organ La State Med Soc. 2004;156(5):245-53.
Berberi A, Noujeim Z, Aoun G. Epidemiology of Oropharyngeal Candidiasis in Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome Patients and CD4+ Counts. J Int Oral Health JIOH. 2015;7(3):20-3.
Munawwar A, Gupta S, Sharma SK, Singh S. Seroprevalence of HSV-1 and 2 in HIV-infected males with and without GUD: Study from a tertiary care setting of India. J Lab Physicians. 2018;10(3):326-31.
Ottria L, Lauritano D, Oberti L, Candotto V, Cura F, Tagliabue A, et al. Prevalence of HIV-related oral manifestations and their association with HAART and CD4+ T cell count: a review. J Biol Regul Homeost Agents. 2018;32(2):51-9.
Chidzonga MM. Noma (cancrum oris) in human immunodeficiency virus/acquired immune deficiency syndrome patients: report of eight cases. J Oral Maxillofac Surg Off J Am Assoc Oral Maxillofac Surg. 1996;54(9):1056-60.
Deb T, Singh NB, Devi HP, Sanasam JC. Head and neck manifestations of HIV infection: a preliminary study. J Indian Med Assoc. 2003;101(2):93-5.
Laskaris G, Hadjivassiliou M, Stratigos J. Oral signs and symptoms in 160 Greek HIV-infected patients. J Oral Pathol Med. 1992;21(3):120-3.
Herdman RC, Forster S, Stafford ND, Pinching AJ. The recognition and management of the otolaryngological manifestations of AIDS. Clin Otolaryngol Allied Sci. 1989;14(4):323-32.
Ondzotto G, Ibara JR, Mowondabeka P, Galiba J. Cervico-facial and ENT symptoms due to HIV infection in tropical area. About 253 Congolese cases. Bull Soc Pathol Exot 1990. 2004;97(1):59-63.
Lee KC, Tami TA, Lalwani AK, Schecter G. Contemporary management of cervical tuberculosis. Laryngoscope. 1992;102(1):60-4.
Cantwell MF, Snider DE, Cauthen GM, Onorato IM. Epidemiology of tuberculosis in the United States, 1985 through 1992. JAMA. 1994;272(7):535-9.
Shapiro AL, Shechtman FG, Guida RA, Kimmelman CP. Head and neck lymphoma in patients with the acquired immune deficiency syndrome. Otolaryngol Head Neck Surg. 1992;106(3):258-60.
Rarey KE. Otologic pathophysiology in patients with human immunodeficiency virus. Am J Otolaryngol. 1990;11(6):366-9.
Riederer A, Bujía J, Vogel T, Wilmes E, Kastenbauer E. Otorhinolaryngologic manifestations in patients infected by the acquired immunodeficiency virus. Acta Otorrinolaringol Esp. 1990;41(5):277-80.