Otolaryngologic manifestations in HIV disease: clinical aspects and treatment

Abstract

HIV is a pandemic infection with cases notified in almost all countries. The reported prevalence of symptoms in the head and neck is about 80%; otolaryngologists may be the first physician to see such patients. Oral manifestations are the most common, followed by neck and sinus manifestations. Otolaryngologic symptoms may be important signs of antiretroviral therapy failure. Symptoms are present in acute infections and advanced cases. Objective To describe new approaches in the past five years for the treatment of the most frequent otolaryngologic manifestations in HIV patients. Methods Systematic reviews and case series published in English and Portuguese from January 2002 to October 2007 including the most common otolaryngology manifestations were selected. Conclusion Otolaryngologic manifestations are common and ENT specialists must be prepared to identify such cases.

Otolaryngological, head and neck manifestations in HIV-infected patients seen at Steve Biko Academic Hospital in Pretoria, South Africa

“…In the other developing countries, oral candidiasis was most prevalent, followed by aphthous ulcers and stomatitis. [10,12] All studies, including ours, showed high rates of cervical lymphadenopathy, head and neck lymph nodes being common signs of systemic disease. [10,12] However, our study is the only one to have documented parotid gland cystic enlargement, revealing that this is an early (WHO stage I or II) manifestation, when immunity is well preserved.…”

“…[10,12] All studies, including ours, showed high rates of cervical lymphadenopathy, head and neck lymph nodes being common signs of systemic disease. [10,12] However, our study is the only one to have documented parotid gland cystic enlargement, revealing that this is an early (WHO stage I or II) manifestation, when immunity is well preserved. Moreover, parotid enlargement is known in the community to be associated with HIV; recognising it as a stigma of infection, patients are motivated to seek a diagnosis and possible cosmetic treatment.…”

“…In the other studies, sinusitis was the most prevalent, followed by allergy-like symptoms and epistaxis. [10,12] Tonsillar hypertrophy was the most common oral manifestation, followed by candidiasis, stomatitis and aphthous ulcers. In the other developing countries, oral candidiasis was most prevalent, followed by aphthous ulcers and stomatitis.…”

Estudo da função auditiva em indivíduos com HIV/AIDS submetidos e não submetidos à terapia antirretroviral

“…It is important to emphasize that the existing abnormalities may occur due to the action of the virus upon the body, the immunosuppression and presence of opportunistic infections, as well as the action of antiretroviral medication and potentially ototoxic medication (5,(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)24) . The specialized literature has shown widely diversified results concerning the occurrence of hearing loss in the population with HIV/AIDS.…”

“…Many different studies in the literature refer that the most frequently observed type of hearing loss in HIV/AIDS adults is sensorineural (5,14,21,24) , followed by conductive hearing loss (21) , and that the impairment is normally bilateral and progressive (2,9,15) . Concerning middle ear impairment, and consequently, presence of conductive or mixed hearing loss, some studies report that this impairment would result from immunosuppression, which favors the presence of opportunistic infections (25) .…”