HIV: An Epidemiologic study on Head and Neck Involvement in 50 Patients

Document Type: Original


1 Sinus and Surgical Endoscopic Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Department of Infectious disease, School of medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

3 Department of Otorhinolaryngology-Head & Neck Surgery, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

4 General Practioner, Mashhad University of Medical Sciences, Mashhad, Iran.


Acquired immunodeficiency syndrome (AIDS) is a worldwide infection. Because of the vast array of manifestations of AIDS and its many atypical presentations, it is becoming increasingly challenging for clinicians to accurately diagnose new lesions.
Materials and Methods:
In a descriptive cross-sectional study conducted from 2007 to 2010, 50 patients with a proven human immunodeficiency virus (HIV) infection were evaluated. Based on the findings of a physical examination and paraclinic tests, HIV signs and symptoms were recorded.
The mean (range) age of the patients was 35.45 ±5.24 (5–55) years. Forty-two (84%) cases were male and eight were female. The mean duration of carrying the virus was 4.51 ±1.03 years. Oral manifestations were the most common (94%), followed by rhinologic (88%), otologic (66%), and finally neck (44%) manifestations.
Head and neck presentations are very common in HIV patients; therefore otolaryngologists, as the first physicians who may encounter such patients, should be aware of this condition.


1. Fauci AS, HIV infections. In: Brawnwald E et al, editors. Harrison’s Principles of Internal Medicine. 16th Ed, New York: Mc-Graw Hill; 2005. P. 1076–1140.

2. Prasad HK, Bhojwani KM, Shenoy V, Prasad SC. HIV manifestations in otolaryngology. Am J Otolaryngol. 2006; 27(3): 179–85.

3. Kim MK, Alvi A. Common head and neck manifestations of AIDS. AIDS Patient Care STDS. 1999; 13(11): 641–4.

4. Reisacher WR, Finn DG, Stern J, Zeifer B, Cocker R. Manifestations of AIDS in the head and neck. South Med J. 1999; 92(7): 684–97.

5. Birchall MA, Wight RG, French PD, Cockbain Z, Smith SJ. Auditory function in patients infected with the human immunodeficiency virus. Clin Otolaryngol Allied Sci. 1992; 17(2): 117–21.

6. Kohan D, Rothstein SG, Cohen NL. Otologic disease in patients with acquired immunodeficiency syndrome. Ann Otol Rhinol Laryngol. 1988; 97(6 Pt 1): 636–40.

7. Rarey KE. Otologic pathophysiology in patients with human immunodeficiency virus. Am J Otolaryngol. 1990; 11(6): 366–9.

8. Chandrasekhar SS, Conelly PE, Brahmbhatt SS, Shah CS, Kloser PC, Baredes S. Otologic and audilogic evaluation of human immunodeficiency virus-infected patients. Am J Otolaryngol. 2000; 21(1): 1–9.

9. Prasad HK, Bhojwani KM, Shenoy V, Prasad SC. HIV manifesta­tions in otolaryngology. Am J Otolaryngol. 2006; 27(3): 179–85.

10. Jafari S, Razmpa E, Saeednejad Z, Sadrhosseini M, Paydari K, Saedi B, et al. Otolaryngological Manifestations in HIV Infected Patients, Tehran, Iran. J AIDS Clinic Res. 2012; 3: 6.

11. Bernaldez P, Morales G, Hernandez C. Chronic Suppurative Oitis Media in HIV-Infected Children. Otolaryngol Head Neck Surg. 2005; 133(2): 243–4.

12. Cheung SW, Lee KC, Cha I. Orbitocerebral complications of pseudomonas sinusitis. Laryngoscope. 1992; 102(12 Pt 1): 1385–9.

13. Cheung SW, Lee KC, Cha I. Orbitocerebral complications of pseudomonas sinusitis. Laryngoscope. 1992; 102(12 Pt 1): 1385–9.

14. Rubin j. Hinni ML, McCaffrey TV, Kasperbauer JL. Early mucosal changes in experimental sinusitis. Otolaryngol Head Neck Surg. 1992; 107(4): 537–48.

15. Rubin JS, Honigberg R. Sinusitis in patients with the acquired immunodeficiency syndrome. Ear Nose Throat J. 1990; 69(7): 460–3.

16. Tami T, Wawrose SF. Disease of the nose and paranasal sinuses in the human immunodeficiency virus-infected population. Oto­laryngol Clin North Am. 1992; 25: 1199–210.

 17. Porter JP, Patel AA, Dewey CM, Stewart MG. Prevalence of sinonasal symptoms in patients with HIV infection. Am J Rhinol. 1999; 13(3): 203–8.

18. Gurney T, Lee K, Murr A. Contemporary issues in rhinosinusitis and HIV infection. Curr Opin Otolaryngol Head Neck Surg. 2003; 11(1): 45–8.

19. Miziara ID, Araujo Filho BC, La Cortina RC, Romano FR, Lima AS. Chronic rhinosinusitis in HIV-infected patients: radiological and clinical evaluation. Rev Bras Otorrinolaringol. 2005; 71(5): 604–8.

20. Pienaar ED, Young T, Holmes H. Interventions for the prevention and management of oropharyngeal candidiasis associated with HIV infection in adults and children. (Cochrane Review). In: The Cochrane Library, Issue 3, 2007. Oxford: Update Software.

21. Kalpidis CDR, Lysitsa SN, Lombardi T, Kolokotronis AE, Anto­niades DZ, Samson J. Gingival involvement in a case series of patients with Acquired Immunodeficiency Syndrome-related Kaposi sarcoma. J Periodontol. 2006; 77(3): 523–32.

22. Baumgarth N, Szubin R, Dolganov GM, Watnik MR, Greenspan D, Da Costa M, et al. Highly tissue substructure-specific effects of human papilloma virus in mucosa of HIV-infected patients revealed by laser-dissection microscopy assisted gene expression profiling. Am J Pathol. 2004; 165(3): 707–18.

23. Smith FB, Rajdeo H, Panesar N, Bhuta K, Stahl R. Benign lymphoepithelial lesion of the parotid gland in intravenous drug users. Arch Pathol Lab Med. 1988; 112(7): 742–5.

24. Staskus KA, Zhong W, Gebhard K, Herndier B, Wang H, Renne R, Beneke J, Pudney J, Anderson
, Ganem D, Haase AT. Kaposi’s sarcoma-associated herpesvirus gene expression in endothelial (spindle) tumor cells. J Virol. 1997; 71(1): 715–9.

25. Miziara ID, Weber R. Oral candidosis and oral hairy leukoplakia a predictors of HAART failure in Brazilian HIV-infected patients. Oral Dis 2006; 12: 402–7.

26. Ranganathan K, Hemalatha R. Oral lesions in HIV infection in developing countries: an overview. Adv Dent Res. 2006; 19(1): 63– 8.

27. Reznik DA. Oral manifestations of HIV disease. Top HIV Med. 2005–2006;13(5):143–8.

28. Hodgson TA, Greenspan D, Greenspan JS. Oral lesions of HIV disease and HAART in industrialized countries. Adv Dent Res. 2006; 19: 57–62.

29. Miziara ID, Araujo Filho BC, Weber R. AIDS e estomatite aftóide recidivante. Braz J Otorhinolaringol. 2005; 71(4): 517–20.

30. Birchall MA, Horner PD, Stafford ND. Changing patterns of HIV infection in otolaryngology. ClinOtolaryngol Allied Sci. 1994; 19(6): 473–7.

31. Gurney T, Murr A. Otolaryngologic manifestations of human immunodeficiency virus infection. Otolaryngol Clin N Am. 2003; 36: 607–24.

32. Mandel L, Surattanont F. Regression of HIV parotid swellings after antiviral therapy: case reports with computed tomographic scan evidence. Oral Surg Oral Med Oral Pathol Oral Raiol Endod. 2002; 94(4): 454–9.

33. Steele NP, Sampogna D, Sessions RB. Kaposi´s Sarcoma of an Intraparotid Lymph Node Leading to a Diagnosis of HIV. Laryn­goscope. 2005; 115: 861–3.