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Alterations of Nasal Mucociliary Clearance in Association with HIV Infection and the Effect of Guaifenesin Therapy
Author(s) -
Rosen Elizabeth J.,
Calhoun Karen H.
Publication year - 2005
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1097/01.mlg.0000150678.83602.d4
Subject(s) - medicine , placebo , mucociliary clearance , human immunodeficiency virus (hiv) , statistical significance , gastroenterology , anesthesia , immunology , pathology , alternative medicine , lung
Objectives: 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. Study Design: 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