Prevalence of Sinonasal Symptoms in Patients with HIV Infection

Abstract

Infection with the human immunodeficiency virus (HIV) is increasing in prevalence, and disease patterns are changing as patient survival lengthens. The purpose of this cross-sectional epidemiological study was to assess the prevalence and severity of self-reported symptoms of otolaryngologic disease in a group of patients attending a general HIV outpatient clinic (n = 203), and to compare the prevalence of self-reported symptoms with a sample of patients without HIV infection (n = 100). Of the HIV-infected patients, 65% of patients had AIDS, 35% were HIV-positive, and the median CD4 count was 135. Although only 11% of patients had seen an otolaryngologist in the prior 6 months, the majority of patients (66%) reported the presence of sinonasal disease during that time. Allergic rhinitis (80%) and sinusitis (54%) were the most commonly reported sinonasal symptoms, and 44% regularly used nasal or sinus medications. Sinonasal disease severity was significantly higher than the self-reported severity of mouth/throat disease (p = 0.01), ear disease (p = 0.03), and neck/salivary disease (p = 0.01). Although patients' self-reported overall health status was associated (p = 0.02) with CD4 count, the severity of sinonasal symptoms was not associated (p = 0.93) with CD4 count. Similarly, sinonasal symptom severity did not differ between HIV-positive and AIDS patients (p = 0.45). In other words, sinonasal disease severity did not improve as general health status improved.

Rinossinusite crônica em pacientes infectados pelo vírus da imunodeficiência humana: avaliação clínica e radiológica

“…Prevalence of this disease in these individuals varied from 10% to 68%, as reported in the literature 1,2,4,5 .…”

“…Porter et al 1 , when comparing seropositive patients -with or without AIDS -, also concluded that the symptoms and severity of rhinosinusitis were similar in both groups. However, we observed in our study that, from radiologically analyses, rhinosinusitis was more severe in AIDS patients, who presented extensive nasosinusal disease.…”

“…Tarp et al 8 , using magnetic resonance imaging, observed a prevalence of 54.3%. Porter et al 1 presented 70% prevalence as a result of a survey on nasosinusal symptoms. In our study, we found a prevalence of 12% among 314 seropositive patients with general otorhinolaryngological complaints who were referred to our otorhinolaryngology ambulatory.…”

“…Chronic rhinosinusitis is the most common affection among HIV-infected patients, particularly those with advanced immunosuppression 1,4 . Prevalence of this disease in these individuals varied from 10% to 68%, as reported in the literature 1,2,4,5 .…”

“…The advent of protease inhibitors, which improves survival and quality of life of patients, has increased the number of asymptomatic HIV-infected individuals worldwide 1,2 . As a consequence, many of these patients have visited otorhinolaryngologists, since 40-70% of them may present some sort of otorhinolaryngological disorder 2,3 .…”