title: The prevalence of xerostomia and salivary gland hypofunction in a cohort of HIV-positive and at-risk women.
abstract: The association of xerostomia and salivary gland hypofunction with HIV infection has been established for men but not for women. We investigated the prevalence of these conditions in a national cohort (n = 733) of HIV-positive and at-risk HIV-negative women. Participants in this prospective cross-sectional study were recruited from the Women's Interagency HIV Study (WIHS) at five outpatient USA clinics. Xerostomia was assessed based on "yes" responses to a dry-mouth questionnaire. Samples of unstimulated whole and chewing-stimulated whole saliva were collected under standardized conditions. The major salivary glands were also evaluated clinically. The prevalence of dry-mouth complaint, the absence of saliva upon palpation, and zero unstimulated whole saliva (flow rate = 0 mL/min) were significantly (p = 0.001) higher in HIV-positive women. Adjusted odds of zero unstimulated whole saliva were significantly (p = 0.02) higher in HIV-positive women vs. HIV-negative women (OR = 2.86; 95% CI, 1.23 to 6.63). Significant (p = 0.03) univariate association was found between zero unstimulated whole saliva and CD4 counts. Adjusted odds of zero unstimulated whole saliva were significantly (p = 0.02) higher for HIV-positive women with CD4 < 200 compared with those with CD4 > 500 (OR = 2.61; 95% CI, 1.17 to 5.85). Chewing-stimulated flow rates were not significantly different between seropositive and seronegative women. The prevalence of xerostomia and salivary gland hypofunction appears to be significantly higher in HIV-positive women relative to a comparable group of at-risk seronegative women. Immunosuppression levels measured by CD4 cell counts are significantly associated with xerostomia and salivary gland hypofunction in a population of HIV-positive women.
authors.affiliation: University of Southern California, School of Dentistry, Department of Dental Medicine & Public Health, Los Angeles 90089-0641, USA. navazesh@hsc.usc.edu
authors.forename: M
authors.initials: M
authors.lastname: Navazesh
authors.forename: R
authors.initials: R
authors.lastname: Mulligan
authors.forename: E
authors.initials: E
authors.lastname: Komaroff
authors.forename: M
authors.initials: M
authors.lastname: Redford
authors.forename: D
authors.initials: D
authors.lastname: Greenspan
authors.forename: J
authors.initials: J
authors.lastname: Phelan
mesh_terms: D000293:Adolescent; D000328:Adult; D018791:CD4 Lymphocyte Count; D016009:Chi-Square Distribution; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D016017:Odds Ratio; D010306:Parotid Gland / Q000503:physiopathology; D011446:Prospective Studies; D012463:Saliva / Q000378:metabolism; D012469:Salivary Glands / Q000503:physiopathology; D012636:Secretory Rate; D018709:Statistics, Nonparametric; D013363:Submandibular Gland / Q000503:physiopathology; D014987:Xerostomia / Q000209:etiology*