AIDS and the pediatric ENT specialist

Otitis media in Brazilian human immunodeficiency virus infected children undergoing antiretroviral therapy

Objective:

To assess changes in the prevalence of otitis media, associated with the use of highly active antiretroviral therapy, in Brazilian human immunodeficiency virus (HIV) infected children.

Setting:

Division of otorhinolaryngology, Hospital das Clínicas, Sao Paulo University Medical School, Brazil.

Patients:

A cohort of 459 HIV-infected children aged below 13 years.

Main outcome measures:

The prevalence of otitis media and the serum cluster of differentiation four glycoprotein T lymphocyte count were compared for children receiving highly active antiretroviral therapy (with protease inhibitors) and those receiving standard antiretroviral therapy (without protease inhibitors).

Results:

Otitis media was present in 33.1 per cent of the children. Children aged from zero years to five years 11 months receiving highly active antiretroviral therapy had a higher prevalence of acute otitis media (p=0.02) and a lower prevalence of chronic otitis media (p=0.02). Children who were receiving highly active antiretroviral therapy had a mean serum cluster of differentiation four glycoprotein T lymphocyte count greater than that of those who were receiving standard antiretroviral therapy (p<0.001).

Conclusions:

The use of highly active antiretroviral therapy in Brazilian HIV-infected children was associated with a lower prevalence of chronic otitis media.

Otorhinolaryngological manifestations in children with human immunodeficiency virus infection

The otorhinolaryngological manifestations (ENTM) in AIDS were first described in 1983. Continuing research confirmed that the ENTM reached up to 100% of the infected individuals. In the infant population, this percentage is also found, differing by presenting specific ENTM. The main objectives of this study were to define the most common ENTM in HIV children and to observe the difference, when compared to non-infected children. The HIV detection was also correlated with the appearance of the first ENTM. The observational, case-control research involved the study of 40 children over a period of 1 year. It was found that HIV children have a higher occurrence of ENTM, herpes simplex virus gingivostomatitis, cervical lymphadenopathy and parotid hypertrophy. On the other hand, the proportion of children who developed rhinosinusitis, acute otitis media (AOM) and oral candidiasis (OC) were not statistically different among the groups. However, 90% of the HIV children presented at least one ENTM, as opposed to 45% of the immunocompetent children. Differences in the occurrence of the ENTM were noticed, some more suggestive of the HIV infection. Furthermore, the majority of the infected children had their first ENTM diagnosed before the infection of HIV was established.

Otolaryngologic manifestations of human immunodeficiency virus infection

Patients infected with HIV have become a steadily increasing part of most medical practices. Because most patients with HIV-related problems have manifestations in the head and neck, it is important that these be understood and recognized. This article briefly reviews the various otolaryngologic manifestations of HIV infection, including otologic, nasal, and paranasal sinus; oral cavity, pharynx, and larynx; and the neck.