Maxillofacial trauma: influence of HIV infection

Between 1986 and 1990, 171 patients with mandibular and 129 with mid-face fractures were treated in our service. Both groups were separated into patients with HIV infection and patients without HIV infection. We carried out a retrospective review of these cases. The incidence of HIV+ve patients was higher in the mandibular fracture group (19.8%) than the group with mid-face fractures (7.75%). The most important aetiology of fractures was violence and the HIV infection was acquired through intravenous drug use (heroin). HIV infection was an independent associated factor where there was concomitant infection of mandibular fractures but not in mid-face fractures. In mandibular fractures, preoperative infections were significantly higher in HIV+ve patients (26.4%) than HIV-ve patients (6.5%) (p < 0.0001). Postoperative infections were higher in HIV+ve cases than HIV-ve cases, but this difference was not statistically significant (p > 0.05). Miniplates were a good osteosynthesis medium in HIV+ve patients and intermaxillary fixation seems to increase the infection rate in the HIV+ve group. The infections were treated with antibiotics with excellent results in preoperative infections and in the majority of postoperative cases, in both HIV+ve and HIV-ve patients.