Effect of HAART on salivary gland function in the Women's Interagency HIV Study (WIHS).
OBJECTIVE
To determine the impact of highly active antiretroviral therapy (HAART) on salivary gland function in human immunodeficiency virus (HIV) positive women from the Women's Interagency HIV Study (WIHS).


METHODS
Longitudinal cohort study.


METHODS
A total of 668 HIV positive women from the WIHS cohort with an initial and at least one follow-up oral sub-study visit contributed 5358 visits. Salivary gland function was assessed based on a dry mouth questionnaire, whole unstimulated and stimulated salivary flow rates, salivary gland enlargement or tenderness and lack of saliva on palpation of the major salivary glands.


METHODS
Changes in unstimulated and stimulated flow rates at any given visit from that of the immediate prior visit (continuous variables). The development of self-reported dry mouth (present/absent), enlargement or tenderness of salivary glands (present/absent), and absence of secretion on palpation of the salivary glands were binary outcomes (yes/no).


RESULTS
Protease Inhibitor (PI) based HAART was a significant risk factor for developing decreased unstimulated (P = 0.01) and stimulated (P = 0.0004) salivary flow rates as well as salivary gland enlargement (P = 0.006) as compared with non-PI based HAART.


CONCLUSIONS
PI-based HAART therapy is a significant risk factor for developing reduced salivary flow rates and salivary gland enlargement in HIV positive patients.
Navazesh
M
M
USC School of Dentistry, Los Angeles, CA 90089-0641, USA. navazesh@usc.edu
Mulligan
R
R
Karim
R
R
Mack
W J
WJ
Ram
S
S
Seirawan
H
H
Greenspan
J
J
Greenspan
D
D
Phelan
J
J
Alves
M
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D019380:Anti-HIV Agents / Q000009:adverse effects / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006678:HIV / Q000235:genetics; D017320:HIV Protease Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D054303:HIV Reverse Transcriptase / Q000037:antagonists & inhibitors; D006679:HIV Seropositivity / Q000188:drug therapy*; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D012367:RNA, Viral / Q000032:analysis; D018894:Reverse Transcriptase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D012307:Risk Factors; D012463:Saliva / Q000187:drug effects / Q000378:metabolism; D012469:Salivary Glands / Q000187:drug effects*; D012636:Secretory Rate / Q000187:drug effects; D012793:Sialadenitis / Q000139:chemically induced; D014987:Xerostomia / Q000139:chemically induced; D055815:Young Adult
D019380:Anti-HIV Agents; D017320:HIV Protease Inhibitors; D012367:RNA, Viral; D018894:Reverse Transcriptase Inhibitors; D054303:HIV Reverse Transcriptase