Abstract
The otorhinolaryngological (ORL) manifestations of Human Immunodeficiency virus (HIV) are common, but remain poorly characterized among children of Sub-Saharan Africa, where 90% of new pediatric infections occur. Our objective was to compare ORL findings and hearing in HIV-positive and -negative children of Luanda, Angola, using a comparative study of 78 outpatients from the HIV polyclinic and of 78 age- and sex-matched controls in a pediatric hospital with interview, general and ORL examination, brainstem auditory evoked potentials, and at age >5 years pure tone open-air audiometry. ORL pathology emerged in 92% of HIV-positive and 78% (p = 0.02) of control children. HIV-associated ORL findings comprised dental caries (56 vs. 32%; p = 0.0009), cervical lymphadenopathy >1 cm (45 vs. 10%; p < 0.0001), facial skin lesions (32 vs. 5.1%; p < 0.0001), chronic suppurative otitis media (26 vs. 3.8%; p = 0.0002), dry tympanic membrane perforations (9 vs. 1%; p = 0.03), tonsils of Mallampati score 0–1 (87 vs. 64%; p = 0.0009), and bilateral hearing loss of >25 dB (13 vs. 1%; p = 0.009). Other HIV-associated characteristics included ear pain (44 vs. 27%; p = 0.006), earlier otorrhea episodes (34 vs. 17%; p = 0.004), tuberculosis (29 vs. 2.6%; p < 0.0001), and pneumonia (22 vs. 2.6%; p = 0.0003). ORL pathology appeared usual in both HIV-positive and -negative children. However, the overall high frequency and severity of the findings among the HIV-positive children require regular inclusion of the ORL area in these children’s clinical evaluation.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Chow JH, Stern JC, Kaul A, Pincus RL, Gromisch DS (1990) Head and neck manifestations of the acquired immunodeficiency syndrome in children. Ear Nose Throat J 69(6):416–419, 422–423
Gondim LA, Zonta RF, Fortkamp E, Schmeling RO (2000) Otorhinolaryngological manifestations in children with human immunodeficiency virus infection. Int J Pediatr Otorhinolaryngol 54(2–3):97–102
Chaloryoo S, Chotpitayasunondh T, Chiengmai PN (1998) AIDS in ENT in children. Int J Pediatr Otorhinolaryngol 44(2):103–107
Williams MA (1987) Head and neck findings in pediatric acquired immune deficiency syndrome. Laryngoscope 97(6):713–716
Dargent JL, Lespagnard L, Kornreich A, Hermans P, Clumeck N, Verhest A (2000) HIV-associated multinucleated giant cells in lymphoid tissue of the Waldeyer’s ring: a detailed study. Mod Pathol 13(12):1293–1299
Bagenda D, Nassali A, Kalyesubula I, Sherman B, Drotar D, Boivin MJ et al (2006) Health, neurologic, and cognitive status of HIV-infected, long-surviving, and antiretroviral-naive Ugandan children. Pediatrics 117(3):729–740
Dave SP, Pernas FG, Roy S (2007) The benign lymphoepithelial cyst and a classification system for lymphocytic parotid gland enlargement in the pediatric HIV population. Laryngoscope 117(1):106–113
Eldridge K, Gallagher JE (2000) Dental caries prevalence and dental health behaviour in HIV infected children. Int J Paediatr Dent 10(1):19–26
Matas CG, Leite RA, Magliaro FC, Goncalves IC (2006) Audiological and electrophysiological evaluation of children with acquired immunodeficiency syndrome (AIDS). Braz J Infect Dis 10(4):264–268
Palacios GC, Montalvo MS, Fraire MI, Leon E, Alvarez MT, Solorzano F (2008) Audiologic and vestibular findings in a sample of human immunodeficiency virus type-1-infected Mexican children under highly active antiretroviral therapy. Int J Pediatr Otorhinolaryngol 72(11):1671–1681
UNAIDS. AIDS epidemic update: November 2009. Geneva 2009; UNAIDS/09.36E/JC1700E
UNAIDS/WHO Working Group on Global HIV/AIDS and STI Surveillance. UNAIDS/WHO Epidemiological Fact Sheets on HIV and AIDS, 2008 Update. Geneva 2008
World Health Organization. WHO case definitions of HIV for surveillance and revised clinical staging and immunological classification of HIV-related disease in adults and children. Geneva 2007
Singh A, Georgalas C, Patel N, Papesch M (2003) ENT presentations in children with HIV infection. Clin Otolaryngol Allied Sci 28(3):240–243
Hadfield PJ, Birchall MA, Novelli V, Bailey CM (1996) The ENT manifestations of HIV infection in children. Clin Otolaryngol Allied Sci 21(1):30–36
Nkrumah FK, Choto RG, Emmanuel J, Kumar R (1990) Clinical presentation of symptomatic human immuno-deficiency virus in children. Cent Afr J Med 36(5):116–120
Chen AY, Ohlms LA, Stewart MG, Kline MW (1996) Otolaryngologic disease progression in children with human immunodeficiency virus infection. Arch Otolaryngol Head Neck Surg 122(12):1360–1363
Shapiro NL, Novelli V (1998) Otitis media in children with vertically-acquired HIV infection: the Great Ormond Street Hospital experience. Int J Pediatr Otorhinolaryngol 45(1):69–75
Balsam D, Kanth N, Balbi H (1995) Abnormally small adenoids in HIV-infected children. Pediatr Radiol 25(1):74–76
Benito MB, Sampelayo TH, Gurbindo D, Sanchez-Ramon BS, Gomez EM, Munoz-Fernandez MA (1999) Adenoidal tissue mass as a clinical guide of disease evolution in vertically HIV-1 infected children. Int J Pediatr Otorhinolaryngol 51(3):145–155
Massarente DB, Domaneschi C, Antunes JL (2009) Untreated dental caries in a Brazilian paediatric AIDS patient population. Oral Health Prev Dent 7(4):403–410
Olusanya BO, Okolo AA, Ijaduola GT (2000) The hearing profile of Nigerian school children. Int J Pediatr Otorhinolaryngol 55(3):173–179
Acknowledgments
We thank all of the participating children and their guardians and the personnel of Hospital Pediátrico. David Bernardino and especially Elizabete Anjos and Marlene Pardal, who mostly performed the laboratory diagnostics in Luanda, are particularly thanked. We also gratefully acknowledge a research grant from the Väinö and Laina Kivi Foundation.
Conflict of interest
The authors declare that they have no conflicts of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Taipale, A., Pelkonen, T., Taipale, M. et al. Otorhinolaryngological findings and hearing in HIV-positive and HIV-negative children in a developing country. Eur Arch Otorhinolaryngol 268, 1527–1532 (2011). https://doi.org/10.1007/s00405-011-1579-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00405-011-1579-x