CHANGING PATTERNS OF HIV-INFECTION IN OTOLARYNGOLOGY

To identify how the spectrum of head and neck complications of HIV dis ease has altered over the 7-year period between 1984 and 1991, a prosp ective 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 pro portion of HIV-positive patients (20/31 1983-1984; 90/179 1989-1991: P < 0.001). While the occurrence of mucosal candidiasis (P < 0.0001) an d Kaposi's sarcoma (P < 0.05) has decreased that of rhinosinusitis (P < 0.0001) and non-Hodgkin's lymphoma (P < 0.05) has increased. Cervica l lymphadenopathy has shown a significant decline (P < 0.05), but othe r conditions have been relatively constant. Otolaryngologists should b e aware of current emphasis in the head and neck manifestations of HIV infection, which have important implications for diagnosis and manage ment.