{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T09:47:16Z","timestamp":1787737636764,"version":"build-2784847793"},"reference-count":34,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2025,5,6]],"date-time":"2025-05-06T00:00:00Z","timestamp":1746489600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Backgrounds and objective: Disorders in the stomatognathic system and otorhinolaryngologic manifestations are frequently observed in individuals living with HIV. Ear, neck, and throat (ENT) signs and symptoms often serve as critical markers of treatment failure, particularly in the advanced stages of HIV infection. This article aims to evaluate and consolidate recent developments in the treatment and management of otorhinolaryngological manifestations in HIV-positive patients. Materials and methods: We carried out a retrospective clinical investigation of patients admitted with HIV\/AIDS in the northeastern region of Romania, hospitalized in the \u201cSt. Parascheva\u201d Clinical Hospital of Infectious Diseases in Iasi. We followed the viro-immunological status correlated with patients\u2019 otolaryngology and dental symptomatology, aiming to emphasize the comorbidities of HIV\/AIDS cases. The study period spanned from 1 January 2020 to 30 November 2024. Results: There were a total of 552 recorded cases of oropharyngeal manifestations in patients with HIV. They were more frequent in men (358 cases, 64.85%) than women (194 cases, 35.15%). The majority of cases were young adults, aged 30 to 39 years, comprising 255 patients (46.19%), and most cases (36.85%) had CD4+ T-lymphocyte values between 200 and 499 cells\/\u03bcL. The most frequent diagnosis was oral candidiasis, recorded in 335 male and 174 female cases (509, 92.21% total). Other notable conditions included gingivitis\/periodontitis, sinusitis\/rhinosinusitis, mastoiditis, and dental abscesses, albeit at lower frequencies. Notably, antifungal therapy with fluconazole was the most frequently employed treatment, followed by aminopenicillins and fluoroquinolones. With respect to the antiretroviral treatment, 83.69% of cases were prescribed a single-pill regimen. Conclusions: The key to the management of HIV-positive patients is a multidisciplinary approach, including an ENT specialist and access to antiretroviral therapy.<\/jats:p>","DOI":"10.3390\/medicina61050855","type":"journal-article","created":{"date-parts":[[2025,5,6]],"date-time":"2025-05-06T11:38:06Z","timestamp":1746531486000},"page":"855","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Oropharyngeal Manifestations in Patients with HIV from Northeastern Romania"],"prefix":"10.3390","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8995-3873","authenticated-orcid":false,"given":"Amelia Elena","family":"Surdu","sequence":"first","affiliation":[{"name":"Department of Implantology, Removable Prostheses and Technology, Faculty of Dental Medicine, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabela Ioana","family":"Loghin","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Faculty of Medicine, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Iasi, Romania"},{"name":"Department of Infectious Diseases, \u201cSt. Parascheva\u201d Clinical Hospital of Infectious Diseases, 700116 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor Daniel","family":"Dorob\u0103\u0163","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, University Hospital of Emergency, 050098 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vlad","family":"H\u00e2rtie","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Clinical Hospital of Emergency \u201cProf. Dr. Nicolae Oblu\u201d, 700309 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u0218erban Alin","family":"Rusu","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, \u201cSt. Parascheva\u201d Clinical Hospital of Infectious Diseases, 700116 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ion","family":"Cecan","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, \u201cSt. Parascheva\u201d Clinical Hospital of Infectious Diseases, 700116 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amelia Andreea","family":"Mih\u0103escu","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, \u201cSt. Parascheva\u201d Clinical Hospital of Infectious Diseases, 700116 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Otilia","family":"Eva","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, \u201cSt. Parascheva\u201d Clinical Hospital of Infectious Diseases, 700116 Iasi, Romania"},{"name":"Department of Otolaryngology, Faculty of Medicine, Apollonia University, 700511 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen Mihaela","family":"Dorob\u0103\u021b","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, \u201cSt. Parascheva\u201d Clinical Hospital of Infectious Diseases, 700116 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e9","DOI":"10.4081\/idr.2012.e9","article-title":"Diagnosis and treatment of HIV-associated manifestations in otolaryngology","volume":"4","author":"Iacovou","year":"2012","journal-title":"Infect. Dis. Rep."},{"key":"ref_2","unstructured":"Hines, L.R., and Jones, B.S. (2022). Stoelting\u2019s Anesthesia and Co-Existing Disease. Diseases Related to Immune System Dysfunction, Elsevier Inc.. [8th ed.]."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"282","DOI":"10.4103\/jomfp.JOMFP_191_17","article-title":"CD4 cell counts and oral manifestations in HIV infected and AIDS patients","volume":"22","author":"Nayyar","year":"2018","journal-title":"J. Oral. Maxillofac. Pathol."},{"key":"ref_4","unstructured":"UNAIDS\/WHO (2025, March 16). On the Fast Track to End AIDS. 2016\u20132021 Strategy United Nations Programme on HIV\/AIDS. Available online: https:\/\/www.unaids.org\/en\/resources\/documents\/2015\/UNAIDS_PCB37_15-18."},{"key":"ref_5","unstructured":"European AIDS Clinical Society: EACS Guidelines Version 12.0 (2025, March 04). October 2023. Available online: https:\/\/www.eacsociety.org\/media\/guidelines-12.0.pdf."},{"key":"ref_6","first-page":"1","article-title":"ENT Manifestations of HIV Infection","volume":"4","author":"Shah","year":"2022","journal-title":"Acta Sci. Otolaryngol."},{"key":"ref_7","unstructured":"Tanzania Commission for AIDS (TACAIDS) Dar es Salaam T, Zanzibar ZAC (ZAC), National Bureau of Statistics (NBS) Dar es Salaam T, and Zanzibar O of CGS (OCGS) (2025, March 16). ICF International Calverton MU. HIV\/AIDS and Malaria Indicator Survey 2011\u20132012. History of AIDS. Available online: https:\/\/dhsprogram.com\/pubs\/pdf\/SR196\/SR196.pdf."},{"key":"ref_8","unstructured":"(2007). WHO Case Definitions of HIV for Surveillance and Revised Clinical Staging and Immunological Classification of HIV-Related Disease in Adults and Children, World Health Organization Library Cataloguing-in-Publication Data."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Preda, M., and Manolescu, L.C.S. (2022). Romania, a Harbour of HIV-1 Subtype F1: Where Are We after 33 Years of HIV-1 Infection?. Viruses, 14.","DOI":"10.3390\/v14092081"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"408","DOI":"10.4103\/ijdr.ijdr_627_22","article-title":"\u201cOral manifestations of HIV in accordance with CD4 count\u201d\u2014A cross-sectional study","volume":"33","author":"Ayyagari","year":"2022","journal-title":"Indian J. Dent. Res."},{"key":"ref_11","first-page":"43","article-title":"Oral manifestations of human immunodeficiency virus-infected patients","volume":"27","author":"Pakfetrat","year":"2015","journal-title":"Iran. J. Otorhinolaryngol."},{"key":"ref_12","first-page":"436","article-title":"CD4 Cell Counts, Lipid Profile, and Oral Manifestations in HIV-Infected and AIDS Patients","volume":"16","author":"Sridevi","year":"2019","journal-title":"Front. Dent."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1111\/odi.13469","article-title":"The global changing pattern of the oral manifestations of HIV","volume":"26","author":"Tappuni","year":"2020","journal-title":"Oral Dis."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1111\/odi.13385","article-title":"The impact of the world Workshops on oral health and disease in HIV and AIDS (1988\u20132020)","volume":"26","author":"Greenspan","year":"2020","journal-title":"Oral. Dis."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1111\/odi.13386","article-title":"Global inequalities in HIV infection","volume":"26","author":"Challacombe","year":"2020","journal-title":"Oral. Dis."},{"key":"ref_16","first-page":"449","article-title":"The influence of antiretroviral therapy on HIV-related oral manifestations","volume":"113","author":"Khoury","year":"2021","journal-title":"J. Natl. Med. Assoc."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1111\/idj.12029","article-title":"Gender differences in oral manifestations among HIV-infected Brazilian adults","volume":"63","author":"Dongo","year":"2013","journal-title":"Int. Dent. J."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"102370","DOI":"10.1016\/j.eclinm.2023.102370","article-title":"Estimates of the global burden of non-Hodgkin lymphoma attributable to HIV: A population attributable modeling study","volume":"67","author":"Chen","year":"2023","journal-title":"EClinicalMedicine"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"724","DOI":"10.1089\/apc.2006.0211","article-title":"Prevalence of oral manifestations of HIV infection in Rio De Janeiro, Brazil from 1988 to 2004","volume":"21","author":"Ferreira","year":"2007","journal-title":"AIDS Patient Care STDS"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"37","DOI":"10.47102\/annals-acadmedsg.V33N4p37S","article-title":"Oral lesions and conditions associated with human immunodeficiency virus infection in 1000 South Indian patients","volume":"33","author":"Ranganathan","year":"2004","journal-title":"Ann. Acad. Med. Singap."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1111\/j.1601-0825.2006.01232.x","article-title":"Oral manifestations in HIV\/AIDS infected patients from India","volume":"12","author":"Sharma","year":"2006","journal-title":"Oral. Dis."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e12351","DOI":"10.1111\/jicd.12351","article-title":"Systematic review of the changing pattern of the oral manifestations of HIV","volume":"9","author":"Tappuni","year":"2018","journal-title":"J. Investig. Clin. Dent."},{"key":"ref_23","first-page":"18","article-title":"Epidemiology and Relationships between CD4+ Counts and Oral Lesions among 50 Patients Infected with Human Immunodeficiency Virus","volume":"7","author":"Berberi","year":"2015","journal-title":"J. Int. Oral. Health"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Keita, A., Rigaill, J., Pillet, S., Sereme, Y., Coulibaly, S., Diallo, F., Verhoeven, P., Pozzetto, B., Thiero, T.A., and Bourlet, T. (2021). Evidence of HIV-1 Genital Shedding after One Year of Antiretroviral Therapy in Females Recently Diagnosed in Bamako, Mali. Microorganisms, 9.","DOI":"10.3390\/microorganisms9102164"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1007\/s00784-007-0118-z","article-title":"Oral manifestations of HIV\/AIDS in clients attending TASO clinics in Uganda","volume":"11","author":"Tirwomwe","year":"2007","journal-title":"Clin. Oral. Investig."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1111\/j.1834-7819.2010.01203.x","article-title":"The mouth in HIV\/AIDS: Markers of disease status and management challenges for the dental profession","volume":"55","author":"Johnson","year":"2010","journal-title":"Aust. Dent. J."},{"key":"ref_27","unstructured":"Department for Monitoring and Evaluation of HIV\/AIDS infection in Romania, National Institute of Infectious Diseases \u201cProf. dr. Matei Bal\u0219\u201d (2025, March 18). Available online: https:\/\/www.cnlas.ro\/images\/doc\/31122022_rom.pdf."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"716","DOI":"10.1007\/s10461-006-9202-7","article-title":"HIV-positive Romanian adolescents: Acquisition routes, risk behaviors, and psychological correlates","volume":"11","author":"Johnson","year":"2007","journal-title":"AIDS Behav."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Hohan, R., Paraschiv, S., Nicolae, I., and O\u021belea, D. (2024). Estimating the Current Routes of Transmission in HIV-1 F1 Subtype Infected Persons in Romania: Differences Between Self-Reporting and Phylogenetic Data. Pathogens, 13.","DOI":"10.3390\/pathogens13110960"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Cobaschi, M., Loghin, I.I., Dorob\u0103\u021b, V.D., Silva\u0219, G., Rusu, \u0218.A., H\u00e2rtie, V., and Aram\u0103, V. (2023). Ophthalmological Manifestations in People with HIV from Northeastern Romania. Medicina, 59.","DOI":"10.3390\/medicina59091605"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"e406","DOI":"10.1016\/S2352-3018(24)00096-1","article-title":"Critical illness due to infection in people living with HIV","volume":"11","author":"Richards","year":"2024","journal-title":"Lancet HIV."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1579","DOI":"10.4102\/sajhivmed.v25i1.1579","article-title":"A multidisciplinary approach for people with HIV failing antiretroviral therapy in South Africa","volume":"25","author":"Juta","year":"2024","journal-title":"South Afr. J. HIV Med."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Apetroaei, M.M., Velescu, B.\u0218., Nedea, M.I.I., Dinu-P\u00eervu, C.E., Dr\u0103g\u0103nescu, D., F\u00e2c\u0103, A.I., Udeanu, D.I., and Arsene, A.L. (2024). The Phenomenon of Antiretroviral Drug Resistance in the Context of Human Immunodeficiency Virus Treatment: Dynamic and Ever Evolving Subject Matter. Biomedicines, 12.","DOI":"10.3390\/biomedicines12040915"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Ple\u0219ca, V.\u0218., Miron, V.D., Marinescu, A.G., Dr\u0103g\u0103nescu, A.C., Ple\u0219ca, A.D., S\u0103ndulescu, O., Voiosu, C., Hain\u0103ro\u0219ie, R., and Streinu-Cercel, A. (2024). Hospitalizations for Acute Otitis and Sinusitis in Patients Living with HIV: A Retrospective Analysis of a Tertiary Center in Romania. J. Clin. Med., 13.","DOI":"10.3390\/jcm13113346"}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/61\/5\/855\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:28:00Z","timestamp":1760030880000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/61\/5\/855"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,6]]},"references-count":34,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2025,5]]}},"alternative-id":["medicina61050855"],"URL":"https:\/\/doi.org\/10.3390\/medicina61050855","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,6]]}}}