Changing patterns of HIV infection in otolaryngology

To identify how the spectrum of head and neck complications of HIV disease has altered over the 7-year period between 1984 and 1991, a prospective collection of data on 429 HIV-positive subjects referred since 1984 was undertaken. Information was grouped into three study periods by date of presentation for analysis of trends. There has been a trend towards increased heterosexual acquisition (P < 0.02) and a decrease over time in the proportion of patients presenting with AIDS, as a proportion of HIV-positive patients (20/31 1983-1984; 90/179 1989-1991: P < 0.001). While the occurrence of mucosal candidiasis (P < 0.0001) and Kaposi's sarcoma (P < 0.05) has decreased that of rhinosinusitis (P < 0.0001) and non-Hodgkin's lymphoma (P < 0.05) has increased. Cervical lymphadenopathy has shown a significant decline (P < 0.05), but other conditions have been relatively constant. Otolaryngologists should be aware of current emphasis in the head and neck manifestations of HIV infection, which have important implications for diagnosis and management.