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Radiographic imaging of sinusitis in HIV infection
M Armstrong1, J C McArthur, S J Zinreich
1Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, MD.
Abstract:
Magnetic resonance images (MRI) of the brain from 75 homosexual men were reviewed to evaluate the frequency and severity of incidental sinus disease associated with human immunodeficiency virus (HIV). All scans had been performed for reasons other than a history of sinus disease. The opacification of each sinus cavity was scored such that 0 = normal, 1 = < 25%, 2 = 25% to 75%, and 3 = > 75% opacification. Subjects were then stratified by clinical status into four groups: HIV-, HIV+ without HIV-related symptoms, AIDS-related complex (ARC), or AIDS. Grade 1 mucosal thickening was present in 52% to 55% of HIV- and HIV+ subjects alike. Moderate disease (grade 2 or 3) was seen in seven of 52 HIV+ subjects, but none of the 23 HIV- controls. The incidence of maxillary sinus thickening was 69% in men with AIDS, compared to 30% in HIV- men (chi 2 = 4.1, p < 0.05). Mean maxillary sinus scores were 1.25 +/- 0.29 in those with AIDS compared to 0.43 +/- 0.15 in HIV- men (f = 5.11, p < 0.05). Our results suggest that maxillary sinus disease is more common and more severe in patients who have AIDS.
Insights
Incidental sinus disease, particularly maxillary sinus thickening, is more prevalent and severe in individuals with acquired immunodeficiency syndrome (AIDS). This finding highlights a potential complication associated with advanced human immunodeficiency virus (HIV) infection.
Area of Science:
- Radiology
- Infectious Diseases
- Otolaryngology
Background:
- Human immunodeficiency virus (HIV) infection can affect various organ systems.
- Incidental findings on neuroimaging studies provide opportunities to assess other conditions.
Purpose of the Study:
- To evaluate the frequency and severity of incidental sinus disease in homosexual men with varying stages of HIV infection.
- To compare sinus disease prevalence between HIV-negative and HIV-positive individuals, including those with AIDS.
Main Methods:
- Retrospective review of 75 brain Magnetic Resonance Images (MRIs) from homosexual men.
- Sinus cavity opacification scored from 0 (normal) to 3 (>75% opacification).
- Subjects stratified into HIV-negative, HIV-positive (asymptomatic), AIDS-Related Complex (ARC), and AIDS groups.
Main Results:
- Moderate to severe sinus disease (grade 2 or 3) was observed in 7 of 52 HIV-positive subjects, but none of the 23 HIV-negative controls.
- Men with AIDS showed a significantly higher incidence of maxillary sinus thickening (69%) compared to HIV-negative men (30%).
- Mean maxillary sinus scores were significantly higher in men with AIDS (1.25 ± 0.29) versus HIV-negative men (0.43 ± 0.15).
Conclusions:
- Maxillary sinus disease is more common and severe in patients diagnosed with AIDS.
- Incidental MRI findings suggest a link between advanced HIV and increased sinus pathology.