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Otolaryngological Manifestations in HIV Infected Patients, Tehran, Iran

Background: Extant literature finds that 80% of HIV-infected patients present with otorhinolaryngological symptoms during the course of the infection. To date, no studies have defined HIV-associated ENT manifestations in Iran. To fill this gap in the literature, this study characterizes ENT signs and symptoms in HIV-infected individuals in Tehran, Iran. 
Methods: The cross-sectional study consisted of 98 HIV infected patients who were referred to a Voluntary Counseling and Testing (VCT) center of Imam Khomeini hospital, Tehran from September 2007 to September 2008. A detailed history and physical examination was conducted for each patient. A questionnaire based on ENT manifestations was designed for the study. Para clinical assessments were carried out if any ENT manifestation was present. Analysis included calculations of mean values of quantitative associations between ENT symptoms and otological and nasopharyngeal complaints as well as ENT symptoms and demographic characteristics. Statistical analysis was estimated using either Chi-square test or t- test. 
Results: Among ENT manifestations, otological and nasopharyngeal complaints were most common. Hearing loss (61%), post-nasal discharge (23.5%), xerostomia (39.8%) and voice change (23.5%) were the most frequently cited complaints by participants. In clinical examination, external otitis (6%), mucosal dryness of nasopharynx (6.1%), candidiasis (9.2%), posterior (7.1%) and anterior (6.1%) lymphadenopathies were also common findings. Lower CD4 count was associated with increased prevalence of oropharyngeal conditions. In addition, the duration of HIV infection was significantly associated with oropharyngeal conditions. 
Conclusion: ENT evaluations are highly recommended for early diagnosis, especially in patients with specific symptoms in unusual locations.