Mucociliary clearance abnormalities in the HIV-infected patient: a precursor to acute sinusitis.
An increasing number of patients with human immunodeficiency virus (HIV) suffer from acute infectious sinusitis, and many suffer recurrent episodes at a higher rate than their non-HIV counterparts. This study investigates a mechanism underlying the increased incidence of sinusitis, that of prolonged mucociliary transport time (MTT). Nasal mucociliary clearance was examined in 30 HIV-infected patients and 30 matched, non-HIV controls using a nasal saccharin transport test. MTTs for the study group and the controls were 11.9 +/- 5.9 minutes and 7.4 +/- 3.7 minutes, respectively. This difference attained statistical significance (P < .05). Study group patients with a history of sinusitis had a mean MTT of 13.7 +/- 6.8 minutes. Those with complaints of "new onset" nasal obstruction since HIV conversion had a mean MTT of 13.5 +/- 6.8 minutes. Statistical significance (P < .05) was found comparing these times to controls, as well as to study patients without these symptoms. These data support an inherent delay of mucociliary clearance in HIV-infected patients which is chronic, possibly irreversible, and, in association with nasal obstruction, represents a major mechanism of both the high acute and recurrent sinusitis rate in this population. The cause of the mucociliary delay is still unclear and needs to be further investigated.
D000208:Acute Disease; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009079:Mucociliary Clearance; D015508:Nasal Obstruction / Q000209:etiology; D010865:Pilot Projects; D012852:Sinusitis / Q000209:etiology*; D013997:Time Factors