Abstract Objectives: To evaluate the prevalence of otolaryngologic disease in children born to mothers infected with human immunodeficiency virus (HIV) and to assess the correlation between HIV disease severity and the incidence density of recurrent otitis media (OM) and sinusitis based on the revised 1994 Centers for Disease Control and Prevention (CDC) clinical-severity index. Design: Case series. Setting: Academic, tertiary care children's hospital. Patients: One hundred forty-five children (73 boys, 72 girls) with vertically acquired HIV infection and 153 (77 boys, 76 girls) children who had maternal exposure to HIV but later were found not to be infected ("seroreverters"), followed up on a regular basis since birth. Main Outcome Measures: Prevalence of recurrent OM (3 episodes in 6 months or 4 episodes in 12 months), sinusitis, parotitis, and lymphadenopathy; incidence density of recurrent OM and sinusitis based on the 1994 CDC clinical-severity index. Results: Sixty-four HIV-infected children (44%) and 13 seroreverters (8.5%) had recurrent OM (P<.001); 29 HIV-infected children (20%) and 1 seroreverter (0.6%) had sinusitis (P<.001). Eight HIV-infected patients developed tympanic membrane perforations and 25 HIV-infected children required otologic surgery. Three HIV-infected patients had parotitis. The incidence density of recurrent OM increased as HIV clinical (P=.001) and immunologic (P=.03) status worsened. In contrast, the incidence density of sinusitis did not significantly correlate with increased HIV disease severity. Conclusion: The prevalence of recurrent OM and sinusitis is significantly greater in HIV-infected children than in seroreverters. The incidence density of recurrent OM also significantly correlates with disease progression in HIV-infected children as measured by the 1994 CDC clinical-severity index.Arch Otolaryngol Head Neck Surg. 1996;122:1360-1363 References 1. Centers for Disease Control and Prevention. First 500000 AIDS cases: United States, 1995 . MMWR Morb Mortal Wkly Rep . 1995;44:849-853. 2. Kline M. Vertical human immunodeficiency virus infection . Curr Top Neonatol . 1996;1:195-223. 3. Davis SI, Byers RH, Lindegren ML, et al. Prevalence and incidence of vertically acquired HIV infection in the United States . JAMA . 1995;274:952-955.Crossref 4. Marcusen DC, Sooy CD. Otolaryngologic and head and neck manifestations of acquired immunodeficiency syndrome (AIDS) . Laryngoscope . 1985;95:401-405.Crossref 5. Centers for Disease Control and Prevention. Revised classification system for human immunodeficiency virus infection in children less than 13 years of age . MMWR Morb Mortal Wkly Rep . 1994;43(No. (RR-12) ):1-10. 6. Lucente FE. Otolaryngologic aspects of acquired immunodeficiency syndrome . Med Clin North Am . 1991;75:1389-1399. 7. Williams M. Head and neck findings in pediatric acquired immunodeficiency syndrome . Laryngoscope . 1987;97:713-716. 8. Sculerati N, Borkowsky W. Pediatric human immunodeficiency virus infection: an otolaryngologist's perspective . J Otolaryngol . 1990;19:182-188. 9. Linstrom CJ, Pincus RL, Leavitt EB, Urbina MC. Otologic neurotologic manifestations of HIV-related disease . Otolaryngol Head Neck Surg . 1993;108:680-687. 10. Barnett ED, Klein JO, Pelton SI, Luginbuhl LM. Otitis media in children born to human immunodeficiency virus-infected mothers . Pediatr Infect Dis J . 1992; 11:360-364.Crossref 11. Principi N, Marchisio P, Tornaghi R, Onorato J, Massironi E, Picco P. Acute otitis media in human immunodeficiency virus-infected children . Pediatrics . 1991;88:566-571. 12. Godofsky EW, Zinreich J, Armstrong M, Leslie JM, Weikel CS. Sinusitis in HIV-infected patients: a clinical and radiographic review . Am J Med . 1992;93:163-170.Crossref 13. Desai SD. Seropositivity, adenoid hypertrophy, and secretory otitis media in adults: a recognized clinical entity . Otolaryngol Head Neck Surg . 1992:107: 755-757. 14. Kielhofner M, Atmar RL, Hamill RJ, Musher DM. Life-threatening Pseudomonas aeruginosa infections in patients with human immunodeficiency virus infection . Clin Infect Dis . 1992;14:403-411.Crossref 15. Strauss M, Fine E. Aspergillus otomastoiditis in acquired immunodeficiency syndrome . Am J Otol . 1991;12:49-53. 16. Park S, Wunderlich H, Goldenberg RA, Marshall M. Pneumocystis carinii infection in the middle ear . Arch Otolaryngol Head Neck Surg . 1992;118:269-270.Crossref 17. Chow JH, Stern JC, Kaul A, Pincus RL, Gromisch D. Head and neck manifestations of the acquired immunodeficiency syndrome in children . Ear Nose Throat J . 1990;69:416-423. 18. Chanock SJ, McIntosh K. Pediatric infection with the human immunodeficiency virus: issues for the otorhinolaryngologist . Otolaryngol Clin North Am . 1989;22:637-660. 19. Birchall MA, Homer PD, Stafford ND. Changing patterns of HIV infection in otolaryngology . Clin Otolaryngol . 1994;19:473-477.Crossref 20. Small CB, Kaufman A, Armenka M, Rosenstreich DL. Sinusitis and atopy in human immunodeficiency virus infection . J Infect Dis . 1993;167:283-290.Crossref 21. Milgrim LM, Rubin JS, Rosenstreich DL, Small CB. Sinusitis in human immunodeficiency virus infection: typical and atypical organisms . J Otolaryngol . 1994; 23:450-453. 22. Beitler JJ, Vikram B, Silver CE, et al. Low dose radiotherapy for multicystic benign lymphoepithelial lesions of the parotid gland in HIV-positive patients: long term results . Head Neck . 1995;17:31-35.Crossref
Archives of Otolaryngology - Head & Neck Surgery – American Medical Association
Published: Dec 1, 1996
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