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Abstract: Alterations of Nasal Mucociliary Clearance in Association with HIV Infection and the Effect of Guaifenesin Therapy

  [ 85 votes ]   [ Discuss This Article ] • January 13, 2005

Laryngoscope. 2005 Jan;115(1):27-30. Rosen EJ, Calhoun KH. From the Department of Otolaryngology-Head and Neck Surgery (e.j.r.), University of Texas Medical Branch, Galveston, Texas; and the Department of Otolaryngology-Head and Neck Surgery (k.h.c.), University of Missouri, Columbia, Missouri, U.S.A. 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. PMID: 15630360 [PubMed - in process]

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