ENT presentations in children with HIV infection

Illnesses of the ear, nose and throat (ENT) are common in children with human immunodeficiency virus (HIV) infection. We reviewed the case files of 107 HIV seropositive children in the paediatric HIV unit at St Mary's Hospital. The prevalence, age of onset and type of ENT disease were reviewed. We also determined sex distribution, maternal country of origin and mode of transmission of HIV. Fifty per cent of the HIV children had ENT illnesses. Fifty-five per cent of the children presented with their first ENT symptom before age 3 years with 98% of the children having ENT manifestations by age 9 years. The commonest ENT diseases were cervical lymphadenopathy (70%), otitis media (46%), oral candidiasis (35%) and adenotonsillar disease (31%). HIV transmission was vertical in 90%. Maternal country of origin was Africa in 70% and the UK in 13%. Compared with previous studies, the proportion of HIV children with ENT problems appears to have decreased. Although our figures report a similar ENT symptom profile, the age at onset of these symptoms has increased.