HIV- Related Xerostomia in Patients from Chenai, India - Symptoms, Signs and Sialometry

1Chennai Dental Research Foundation, Chennai, India, 2Ragas Dental College & Hospital, Chennai, India

Objectives: Xerostomia may be a problem in HIV-infected patients. The role of saliva and its importance in oral health maintenance was evaluated by questionnaire [Xerostomia Inventory (XI)], oral clinical evaluation and flow rate measurement of whole mouth fluid.

Methods: HIV seropositive patients (Study group n=100) attending a HIV care centre in Chennai, India were examined and compared with HIV seronegative controls (n=100). The patients were asked to complete a structured XI [19 questions with 4 response options (always, frequently, occasionally, never)] to assess the subjective symptoms of dry mouth. The clinical assessment was recorded in a structured case record. Unstimulated and stimulated saliva was collected by a standardised collection procedure (spit method). 2% citric acid was used in the stimulated test. The data was analysed using SPSS 10.0.5.

Results: STUDY GROUP (n=100) Male-71%, Females-29%, Age (years) mean ±SD: 34 ± 7.68, USFR (ml/min) mean ± SD: 0.41 ± 0.12, SFR (ml/min) mean ± SD: 0.77 ± 0.20 ml/min. CONTROL GROUP (n=100) Male-73%, Females-27%. Age (years) mean ± SD: 29 ± 6.28, USFR (ml/min) mean ± SD: 0.60 ± 0.37), SFR (ml/min) mean ± SD: 1.04 ± 0.45. The study group showed significant decrease in USFR and SFR than the controls (P= 0.00). The study group showed gingivitis (80%), pigmentation (24%), candidiasis (15%) and periodontitis (13%). The controls showed gingivitis (25%) and periodontitis (9%). The questions reflecting the status of salivary flow rate were that 14% had to sip liquids to aid swallowing (P=0.02), 20% felt dry (p=0.06),6% had burning sensation(p=0.05)and 6% had altered taste sensation(p=0.01). The correlation between Xerostomia and age were patients with less than 30 years had USFR and SFR of 0.61 and 1.052 ml/min respectively, Patients with age group of 30-40 years had USFR and SFR of 0.46 and 0.85 ml/min respectively, patients with age above 40years had USFR and SFR of 0.38 and 0.71 ml/min. By gender the males had a USFR and SFR of 0.51 and 0.92 ml/min and females had 0.47 and 0.85 mnl/min respectively. In the study group 67% were not on antiretroviral medication (ART) and had USFR and SFR of 0.42 and 0.77 ml/min. 17% were on ART had USFR and SFR of 0.41 and 0.81 ml/min. 16% were on Highly active antiretroviral treatment(HAART) had USFR and SFR of 0.37 and 0.70 ml/min.

Conclusions: The XI was correlated with age - younger age had higher USFR and SRF. Males had higher USFR and SFR than females. Patients on HAART had lowest USFR and SFR followed by ART and patients not on ART. The clinical evaluation in the study group showed dry mucosa was associated with Oral pigmentation (24%), candidiasis (15%) and periodontitis (13%).