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HIV suppression, smoking cessation, and selective use of medications can reduce dry mouth associated with HIV infection

Nearly 30 percent of people infected with the human immunodeficiency virus (HIV) that causes AIDS are bothered by dry mouth. This condition may be associated with salivary gland dysfunction and can affect a persons' ability to chew food and speak. Optimizing HIV suppression, smoking cessation, and tailoring antidepressant and antituberculosis(TB)/anti-Mycobacterium avium (MAC) drugs may decrease dry mouth symptoms among HIV-infected individuals, according to a recent report from the HIV Cost and Services Utilization Study (HCSUS), which is supported in part by the Agency for Healthcare Research and Quality (HS08578).

Researchers from the University of California, Los Angeles, and RAND analyzed the relationship between patient reports of oral dryness and demographic, economic, behavioral, clinical, and treatment characteristics in a nationally representative population of adults receiving HIV care in the United States. An estimated 29 percent of people with HIV, or about 65,000 people, complained of dry mouth. Of these, 37 percent had extreme discomfort, 33 percent had moderate discomfort, and 30 percent had little or no discomfort.

Compared with whites, Hispanics were 61 percent more likely to report dry mouth. Those who were unemployed (perhaps a proxy for debilitation) were more likely to report dry mouth than employed people. Compared with nonsmokers, current smokers also were more likely to report dry mouth. Users of antidepressant drugs and anti-TB/anti-MAC antibiotics were more likely to report dry mouth than those not using these drugs. Finally, compared with patients who had an undetectable viral load, those with a viral load of more than 100,000/mm3 (advanced HIV disease) were more likely to complain of dry mouth, indicating a potential link between HIV disease progression and increased salivary gland dysfunction. The researchers suggest that doctors examine the salivary glands of HIV patients and monitor those with early dry-mouth symptoms.

More details are in "Self-reported oral dryness and HIV disease in a national sample of patients receiving medical care," by Fariba S. Younai, D.D.S., Marvin Marcus, D.D.S., M.P.H., James R. Freed, D.D.S., M.P.H., and others, in the December 2001 Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontics 92, pp. 629-636.

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