Sinus infections affect around 30% of the general population each year. It occurs when the normally air-filled sinus becomes congested with fluid and the lining of the sinuses become inflamed. The most common causes are either a viral or bacterial infection in the upper respiratory system. The effect is deep pressure and pain around the cheekbones, eyes, and sometimes down into the jaw. In an otherwise healthy individual, this infection will clear up on its own without intervention. If the infection persists or deemed severe, antibiotics are prescribed until the symptoms subside.
Nasal infections in HIV patients, however, have a higher rate of incidence and are difficult to treat. Initial understanding of both trends was due to the nature of HIV itself. The virus attacks the immune system directly, resulting in the production of fewer white cells to fight infections. Importantly, CD4+ cells (white cells that are an essential part of triggering immune system) are targeted, resulting in immunodeficiency. The effect is that the patient is far more susceptible to opportunistic infections. As a common cold can lead to sinusitis, it is not surprising the rate of sinus infection is higher in an immuno-comprised patient like those infected with HIV. Additionally, due to a lower CD4 count caused by the virus, sinusitis frequently becomes chronic in HIV patients.
There may also be a direct link between HIV and sinusitis not based on solely a weakened immune system. Research has indicated HIV alters the composition of the mucous produced to clear nasal passages naturally. In HIV patients this mucous isn’t providing a comprehensive protective layer in the sinuses and this contributes to the susceptibility of an infection taking hold.
Recently though, treatment for HIV has improved and with it, the incidence of sinus infection in HIV patients has reduced dramatically from its peak in the early ’90s, when 60-80% of all HIV patients were diagnosed with sinusitis.