Cognitive deficits are associated with HIV disease, and HIV-related cognitive deficits have been associated with declines in everyday functioning and vocational status. We administered a baseline neuropsychological (NP) test battery designed to assess estimated full-scale IQ, achievement, attention/concentration, executive function, language, mental speed, motor function, nonverbal memory, verbal memory, and visual-spatial function to a sample of 174 disabled, HIV-positive individuals enrolled in a randomized, controlled trial of a vocational-rehabilitation program. We then used these NP scores to predict employment at the end of participants’ study participation, using both hierarchical multiple regression and ordinal logistic regression models. The hierarchical multiple regression analyses did not predict participants’ employment activities at the end of study participation. In the ordinal logistic regression model, executive functioning weakly predicted employment status at the end of study participation and inspection of the predicted classifications revealed that 63% of the participants were incorrectly classified using this model. These results suggest that although predicting workforce reentry from NP testing may be statistically significant, NP testing may be of limited clinical value for informing the workforce reentry of disabled people with HIV who are interested in returning to work. (JINS, 2010, 16, 38–48.)

Over a period of 10 years 17 human immunodeficiency virus(HIV)-infected patients with laryngeal Kaposi's sarcoma were seen and treated at University College London Hospitals. All patients had advanced HIV disease. Their presentation was with symptoms of upper airway obstruction in the majority of cases and the diagnosis was made by fibreoptic examination of the larynx. Biopsy was associated with brisk haemorrhage in one patient, who required a temporary tracheostomy, and was not performed in the other 16 cases. The commonest site of laryngeal involvement was the supraglottis in 11 patients, with glottic lesions noted in eight patients: subglottic lesions were seen in only three. Treatment of laryngeal Kaposi's sarcoma was, in general, conservative, five patients received low dose radiotherapy to the larynx and 10 were treated with systemic chemotherapy for disseminated Kaposi's sarcoma. Laryngeal Kaposi's sarcoma did not contribute to patient mortality.

A nasopharyngeal carcinoma was the first event in an otherwise symptom free HIV person. No reports of simultaneous nasopharyngeal carcinoma and HIV infection are known to us. A 46-year-homosexual man was admitted to the ENT department with a three week history of pain in the throat referred to the left ear. He was found to have an irregular tumour in the nasopharynx with a lymph node metastasis to the left side of the neck. The poor response to radiotherapy and the very aggressive progress after treatment raised suspicion of a co-existing disease process. The risk of sexually transmitted HIV was confirmed post mortem and could explain the rapid progression of the tumour. No anti-HIV treatment was given concurrently with radiotherapy.