Alterations of nasal mucociliary clearance in association with HIV infection and the effect of guaifenesin therapy.
OBJECTIVE
To determine if human immunodeficiency virus (HIV) infection is associated with a prolonged mucociliary clearance time (MCT) and to evaluate the effect of guaifenesin on MCT in HIV+ patients.


METHODS
A cross-sectional study comparing HIV+ and HIV- volunteers followed by a prospective, randomized, double-blind, placebo-controlled study of HIV+ patients before and after guaifenesin treatment.


METHODS
Twenty-five HIV+ patients and 29 HIV- controls were enrolled and MCT was measured using the saccharin method. A separate group of 20 HIV+ patients participated in the second arm of the study and underwent saccharin testing before and after a 3-week course of guaifenesin or placebo. All study participants completed a medical history questionnaire, a sinonasal symptom (SNOT-16) survey, and were examined with both anterior rhinoscopy and rigid nasal endoscopy.


RESULTS
There was a significant difference (P < .002) in the MCT between the HIV+ group (13.3 +/- SD 7.5 minutes) and the HIV- controls (9.2 +/- SD 3.9 minutes). The difference in MCT between the guaifenesin and placebo groups did not reach statistical significance (P >.05). The HIV+ group had a higher SNOT-16 score compared to HIV- controls (21.1 vs. 7.4, P < .001). Guaifenesin therapy in HIV+ patients led to a significant improvement in the SNOT-16 score (P < .05).


CONCLUSIONS
Compared to HIV- controls, HIV+ patients have a prolonged MCT and more sinonasal symptoms as indicated by a higher SNOT-16 score. Guaifenesin therapy was associated with improved SNOT-16 scores, although there was not a detectable improvement in MCT. Use of guaifenesin in HIV+ patients with sinonasal disease may lead to improved patient perception of quality of life.
Rosen
Elizabeth J
EJ
Department of Otolaryngology-Head and Neck Surgery, University of Texas Medical Branch, Galveston, TX, USA. elizabeth.rosen@kp.org
Calhoun
Karen H
KH
D000328:Adult; D004311:Double-Blind Method; D005100:Expectorants / Q000494:pharmacology*; D005260:Female; D006140:Guaifenesin / Q000494:pharmacology*; D015658:HIV Infections / Q000150:complications / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009079:Mucociliary Clearance / Q000187:drug effects*; D009297:Nasal Mucosa / Q000503:physiopathology*; D012439:Saccharin; D012852:Sinusitis / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology
D005100:Expectorants; D006140:Guaifenesin; D012439:Saccharin