A 4-year longitudinal evaluation of xerostomia and salivary gland hypofunction in the Women's Interagency HIV Study participants.
OBJECTIVE
Our purpose was to conduct a longitudinal investigation of xerostomia and salivary gland hypofunction in a national cohort of HIV-positive and at-risk HIV-negative participants in the Women's Interagency HIV Study. Study design. Data included responses to a dry mouth questionnaire, clinical evaluations of major salivary glands, and unstimulated and chewing-stimulated whole salivary flow rates. Repeated measures regression models were used to determine factors associated with xerostomia and salivary gland hypofunction.


RESULTS
Significant univariate associations were found between HIV status and reports of "too little saliva" (P <.0001), < or = 0.1 mL/min, unstimulated saliva (P =.01), and lack of saliva upon palpation of parotid (P =.02) and submandibular/sublingual salivary glands (P =.03). Adjusted odds of reports of "too little saliva" were significantly higher for HIV-positive participants (odds ratio [OR] = 2.44; 95% CI, 1.49 - 3.97; P =.0004) than for HIV-negative participants. Among HIV-positive women, adjusted odds of reports of "too little saliva" and of < or = 0.7 mL/min chewing-stimulated saliva were significantly higher for those with CD4 < 200 (OR = 1.58; 95% CI, 1.07-2.34; P =.022; and OR = 1.53; 95% CI, 1.05-2.23; P =.027, respectively) and for those with CD4 200-500 (OR = 1.47; 95%CI, 1.07-2.02; P = 0.016; and OR = 1.37; 95% CI, 1.01-2.31; P =.001, respectively) than for those with CD4 > 500. Also, adjusted odds of < or = 0.1mL/min unstimulated saliva and < or = 0.7 mL/min chewing-stimulated saliva were significantly higher in women on highly active antiretroviral therapy (HAART) (OR = 1.25; 95% CI, 1.05 - 1.50; P =.014) than in women not on HAART (OR = 1.34; 95% CI, 1.01 - 1.79; P =.044).


CONCLUSIONS
HIV-positive women are at a significantly higher risk for xerostomia and salivary gland hypofunction than HIV-negative women, and low CD4 cell counts and HAART use are significant risk factors for these conditions.
Navazesh
Mahvash
M
University of Southern California, Los Angeles, California 90089-0641, USA. navazesh@usc.edu
Mulligan
Roseann
R
Barrón
Yolanda
Y
Redford
Maryann
M
Greenspan
Deborah
D
Alves
Mario
M
Phelan
Joan
J
D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000503:physiopathology; D018023:HIV Seronegativity; D006679:HIV Seropositivity / Q000150:complications / Q000503:physiopathology; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D016017:Odds Ratio; D010306:Parotid Gland / Q000378:metabolism; D011446:Prospective Studies; D012044:Regression Analysis; D012463:Saliva / Q000378:metabolism*; D012636:Secretory Rate / Q000502:physiology; D013361:Sublingual Gland / Q000378:metabolism; D013363:Submandibular Gland / Q000378:metabolism; D014987:Xerostomia / Q000150:complications* / Q000503:physiopathology
D019380:Anti-HIV Agents