AIDS is a fatal disease caused by the human T cell Lymphotrophic virus [HTLV III] known as human immunodeficiency virus [HIV]. The immune system of a person is lowered so much that opportunity organism set up intracellular infections. The most common route of spread for this organism is the through unprotected sexual intercourse, homosexuals, transfusion or contact of an ulcerated area with infected blood or body fluids.

Clinical Features

The disease is characterized by 3 stages:

- initial viraemia:

- latent period

- advanced stage

Otorhinolaryngological Manifestations

Incidence: more than 40% of patients with AIDS develop these.

1> Throat

a) candidiasis- oral cavity, pharynx, larynx and oesophagus which can cause dysphagia

b) chronic cough and dyspnoea may be present

c) herpes simplex infection of he lips, mouth and larynx may occur

2> Nose- chronic rhinitis, sinusitis and fungal sinusitis can occur

3> Ears

a) otitis media

b) sensorineural deafness

c) Facial palsy

4> Neck persistent generalized lymphadenopathy mainly of cervical lymph nodes.

5> Kaposi’s sarcoma: cutaneous, mucosal or pharyngeal types. This sarcoma is multi centric and non-invasive. There is proliferation of spindle cells of vascular origin.

6> Non- Hodgkins Lymphoma

Investigations

1) ELISA test is highly sensitive

2) Western Blot test is used for conformation and is extremely reliable.

3) Blood examination reveals anaemia, leucopenia and thrombocytopenia in late stages.

4) CD4T helper cell keeps dropping with progression of the disease.

Treatment

1) Antibiotics and antifungals to control opportunistic infections

2) Symptomatic management

3) Antiretroviral Drugs:

a) nucleoside analogues like zidovudine and didanosine

b) protease inhibitors like saquinavir and ritonavir.

c) Combination of antiretroviral drugs.