Otorhinolaryngologic Manifestations of Human Immunodeficiency Virus Infection in Manila, the Philippines

• Main Authors: Anna Carlissa P. Arriola, Antonio H. Chua, Rosario Jessica F. Tactacan-Abrenica
• Format: Article
• Language: English
• Published: Philippine Society of Otolaryngology-Head and Neck Surgery, Inc. 2015-12-01
• Series: Philippine Journal of Otolaryngology Head and Neck Surgery
• Subjects: HIV, Otorhinolaryngologic diseases, CD4 Lymphocyte Count, Anti-Retroviral Agents, Stomatitis, Rhinitis; Anna Carlissa
• Online Access: https://pjohns.pso-hns.org/index.php/pjohns/article/view/337
• ISSN: 1908-4889; 2094-1501

Objective: To determine the prevalence of otorhinolaryngologic (ENT) manifestations in people living with Human Immunodeficiency Virus (HIV) infection seen in our institutions, and to determine the association of these manifestations with age, sex, CD4 count and antiretroviral treatment. Methods: Study Design: Cross-Sectional Study Setting: Two Tertiary Government Hospitals Subjects: Adult patients (>19 years old) confirmed to be HIV- infected  were seen at Jose R. Reyes Memorial Medical Center and San Lazaro Hospital from February to July 2014. A data sheet regarding ENT manifestations was filled upon examination. Age, sex, CD4 count and antiretroviral treatment data were recorded. Independent samples t-test was used to determine age association with manifestations. Fischer’s exact test was used to determine association of sex and manifestations. Chi-square test of independence was used to determine association of CD4 count and antiretroviral treatment with manifestations. Association was considered statistically significant if p< 0.05. Results: Three hundred one patients participated with 287 males (95.3%) and 14 females (4.7%). The mean age was 31.7 ± 8. One hundred ninety seven (65.4%) had ENT manifestations. The most common areas of manifestations came from the oral cavity-oropharyngeal area (n=104, 37%), nasal cavity-nasopharyngeal area (n=73, 26%) and ear (n=43, 15%). The most frequent manifestations were cervical lymphadenopathy, aphthous stomatitis and acute rhinitis. There was no significant difference in the age (p=0.31) and sex (p=0.15) of patients with and without manifestations. However, there was a direct association of manifestations with low CD4 count (p<0.001) and inverse association with antiretroviral treatment (p=0.036). Conclusion: Our findings emphasize the importance of screening for ENT manifestations, regular CD4 monitoring and enrollment to antiretroviral therapy in persons with HIV. Baseline otorhinolaryngologic examination upon HIV diagnosis and prior to initiating treatment should be followed by regular surveillance. Conversely, physicians should also be aware that patients with ENT manifestation may have HIV infection. Keywords:   HIV, Otorhinolaryngologic diseases, CD4 Lymphocyte Count, Anti-Retroviral Agents, Stomatitis, Rhinitis