Xerostomia and hyposalivation in HIV positive patients with and without HAART

Abstract

Introduction: Xerostomia and reduced salivary flow have been reported often enough among HIV positive patients. Strong associations have also been established between HIV infection and oral effects of reduced salivary flow like xerostomia, high DMFT, increased candidial infection etc. Besides the direct effect of HIV infection, xerostomia and reduced salivary flow have also been reported as a side effect of Highly Active Anti Retroviral reatment (HAART). Studies have shown that xerostomia has a negative effect on the quality of life of people living with HIV & AIDS. Although reduced salivary flow is a main cause for xerostomia, complaints of xerostomia is also found in the absence of salivary flow deficiency. An exact correlation between the two is not always found.Aim: The aim of this study is to compare the prevalence of xerostomia and hyposalivation, in HIV positive patients on HAART, HIV positive patients not on HAART and HIV negative patients, attending Empilweni Gompo community health centre (EGCHC) in East London. Study Methods: This is a cross sectional analytical study. Xerostomia and resting & chewing- stimulated salivary flow rates were measured for 150 patients who were from three groups : group 1-HIV negative, group 2-HIV positive not on HAART and group 3-HIV positive on HAART for more than two years. Each group had 50 patients. Xerostomia was measured using a questionnaire and salivary flow rates were calculated after saliva collection over a three minute period. Results: There was significant difference in the prevalences for xerostomia (p=0.006) and less than normal chewing -stimulated flow rate (p=0.041) among the three groups with the HIV positive group not on HAART showing the greatest deficiency. HAART was not found to have a negative effect on salivary function. A statistical significance was also observed while comparing mean resting (p=0.010) and chewing –stimulated (p=0.034) salivary flow rates among the three groups. The mean salivary flow rate of those complaining of xerostomia was found to be significantly lower than that of those who did not have xerostomia (p=0.005). Conclusion: HIV positive patients not on HAART are more vulnerable to salivary gland dysfunction. HAART in itself does not to adversely affect xerostomic perceptions or salivary flow rates.The xerostomia questionnaire is a useful tool in indicating those with possible low salivary flow rates