Laryngeal disorders in people living with HIV.

Abstract

OBJECTIVES\nSeveral studies have shown that HIV infected individuals are at higher risk compared to the general population of developing non-AIDS defining conditions such as some types of cancer, kidney disease, liver disease and others. In this case-control study, we compared the incidence of laryngeal disorders between a treatment-seeking HIV-positive population and uninfected controls. We aimed to investigate whether there are any laryngeal disorders that are overrepresented in HIV-positive individuals.\n\n\nMETHODS\nThis was a case-control study based on retrospective chart review, comparing the incidence of laryngeal, airway, and swallowing disorders in sixty-nine HIV positive individuals and 4178 HIV negative controls treated between January 1, 2016 and December 31, 2017, at the Johns Hopkins Voice Center.\n\n\nRESULTS\nA majority of HIV-infected patients (59.4%) had at least one diagnosis belonging to the Vocal cord pathology category compared to 48.2% of controls (OR 1.57, p\xa0=\xa00.065). Compared to the entire treatment-seeking population, HIV patients were more likely to present with laryngeal cancer (15.9% vs. 3.4% in controls, OR 5.43, p\xa0<\xa00.001) and chronic laryngitis (17.4% vs. 4.2%, OR 4.79, p\xa0<\xa00.001). Fungal and ulcerative laryngitis were also overrepresented in HIV-positive individuals (OR 9.45, p\xa0<\xa00.001 and 6.29, p\xa0<\xa00.001, respectively). None of the diagnoses categorized as functional voice disorders, swallowing, or airway problems showed a significant difference between groups. Laryngeal papillomatosis, which is an HPV-dependent disease, had similar prevalence in both groups.\n\n\nCONCLUSIONS\nTreatment-seeking HIV-positive patients presenting to a laryngology clinic suffer significantly more often from laryngeal squamous cell carcinoma as well as chronic, fungal, and ulcerative laryngitis compared to HIV-negative individuals.\n\n\nLEVEL OF EVIDENCE\n4.