Contemporary issues in rhinosinusitis and HIV infection

The medical issues involving patients infected with HIV continue to evolve dramatically. As they live longer sustained on antiretroviral therapy, their prevalence of acute and chronic sinusitis has increased. The common infectious causes of rhinosinusitis found in the general population are often the culprits in HIV-infected patients. However, as their CD4 counts dip below 200 cells/mm, these patients become susceptible to more opportunistic infections and neoplasms. The diagnostic and therapeutic measures used should reflect the physician's suspicion for these usual causes. The otolaryngologist should manage these patients aggressively because sinusitis can have a significant impact on the patients' quality of life as well as survival. Selected patients with either recurrent or chronic sinusitis may benefit from endoscopic sinus surgery.