title: Increased risk of deep neck infection among HIV-infected patients in the era of highly active antiretroviral therapy--a population-based follow-up study.
abstract: BACKGROUND
  Deep neck infections (DNIs) in HIV-infected patients often produce severe complications, even death. Data on the incidence rates and risks of DNI among HIV-infected patients are scarce, particularly with the widespread use of highly active antiretroviral therapy (HAART). We evaluated the incidence rates and risks for DNI among HIV-infected patients and observed the long-term trends.
  
  
  METHODS
  A total of 9888 new HIV-infected patients diagnosed in 2001-2007 were included and matched with 49440 randomly selected subjects. The HIV-infected subjects were offered free access to HAART. All subjects were traced until December 2009. A Kaplan-Meier analysis generated the cumulative DNI incidence rate. The adjusted hazard ratio was computed using Cox proportional hazard regressions.
  
  
  RESULTS
  From the HIV-infected and comparison cohorts, 222 individuals (57.01 cases per 10000 person-years) and 735 individuals (35.54 cases per 10000 person-years) developed DNI, respectively. The log rank test indicated that patients with HIV had a significantly higher 8-year incidence rate of DNI than the control group (P < 0.0001). The adjusted hazard ratio for developing DNI after an HIV attack during the mean 3.94 years follow-up period was 1.59. The incidence rate and relative risk of DNI were 74.58 (per 10000 person-years) and 2.05 (P < 0.0001). Both figures were highest in the first follow-up year and decreased year-by-year thereafter.
  
  
  CONCLUSIONS
  The risk of developing DNI is significantly elevated among HIV-infected patients, even with free access to HAART. Additional research is needed to examine the role of HAART in reducing the risk.
authors.forename: Ching-Feng
authors.initials: CF
authors.lastname: Liu
authors.forename: Shih-Feng
authors.initials: SF
authors.lastname: Weng
authors.forename: Yung-Song
authors.initials: YS
authors.lastname: Lin
authors.forename: Chih-Sheng
authors.initials: CS
authors.lastname: Lin
authors.forename: Ching-Feng
authors.initials: CF
authors.lastname: Lien
authors.forename: Jhi-Joung
authors.initials: JJ
authors.lastname: Wang
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active / Q000706:statistics & numerical data*; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology* / Q000382:microbiology; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009333:Neck; D016016:Proportional Hazards Models; D018461:Soft Tissue Infections / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality / Q000821:virology; D013624:Taiwan / Q000453:epidemiology