Association between Sex, CD4 Cell Counts, Antiretroviral Medications, and Olfactory and Gustatory Functions of HIV‐Infected Adults

Abstract

Objective To investigate the olfactory and gustatory functions of human immunodeficiency virus (HIV)-infected adults in Ibadan, Nigeria. Study Design A cross-sectional study of olfactory and gustatory functions of HIV-infected adults between March 2015 and December 2015. Setting Tertiary health institution. Subjects and Methods A structured questionnaire was administered to participants to obtain relevant sociodemographic and clinical information. Participants' nadir and most recent CD4 cell count and viral loads were obtained from their medical records. Participants' body mass indices were determined, and each subjectively rated their olfactory and gustatory performances. Objective olfactory and gustatory functions were determined using validated "Sniffin' Sticks" and "Taste Strips" impregnated with 4 different concentrations of sucrose, quinine hydrochloride, sodium chloride, and citric acid. Results In total, 135 HIV-infected adults, comprising 41 (30.4%) men and 94 (69.6%) women, were evaluated. Their ages ranged from 20 to 70 years, mean 43.4 ± 10.4 years. Participants were on highly active antiretroviral therapy for a mean duration of 75.8 ± 36.9 months. The proportions of male participants in HIV stages 1, 2, and 3 were 18 (43.9%), 19 (46.3%), and 4 (9.8%), respectively, while female participants were 46 (48.9%), 41 (43.6%), and 7 (7.4%), respectively. Participants' mean olfactory threshold, discrimination, identification, and TDI scores were 8.0 ± 4.9, 9.9 ± 4.7, 8.8 ± 4.5, and 26.7 ± 11.1, respectively, while total taste score was 25.1 ± 5.7. Conclusion HIV-infected adults have tendency to develop hyposmia and hypogeusia. These are worse with advanced stage of HIV infection.

Olfactory identification in HIV positive adults living in Benin city, Nigeria

“…5,28 These values are much lower than the prevalence of 69.8% found in this study but close to the 68.9% found in the identification component of the TDI score in HIV positive adults in another hospital in southern Nigeria. 21 Latest CD4+ count did not correlate with olfactory identification ability in this study, and lowest (nadir) CD4+ count with a p value of 0.053 did not meet the criteria for statistical significance using chi-squared test of association. This is similar to findings by Zucco in Italy and Fasunla in Ibadan and highlight the role of the HIV virus in OI impairment independent of disease severity.…”

“…This is similar to findings by Zucco in Italy and Fasunla in Ibadan and highlight the role of the HIV virus in OI impairment independent of disease severity. 21,27,29 It is contrary to findings in Italy where OI scores worsened with reducing CD4+ count. 30 That study however did not use the WHO staging system and employed a different methodology.…”

“…This reflects the effect of HAART causing improved immunity in these patients and has been demonstrated elsewhere. 5,21,24 Of the HIV positive cases 69.8% had abnormal smell compared to 44.2% of controls which was statistically significant (p= 0.001, OR 2.02 95% CI (0.94-4.31)). Reduced olfaction in HIV positive patients has been documented in several studies.…”

“…This finding has been relatively consistent across different studies and is present from childhood. [21][22][23] It is theorized that this may be due to female advantage in verbal processing or due to hormonal influences. 22,23 In the same vein, level of education differed significantly between cases and controls in this study with the control group having most participants (80.2%) with tertiary level of education compared with just 27.9% of cases.…”

“…Reduced olfaction in HIV positive patients has been documented in several studies. 5,21,[25][26][27][28] In Ilorin, Nigeria Alabi and co-workers found complaints of Anosmia in 30.3% of HIV positive adults while in Ibadan a study in HIV positive women found the prevalence of olfactory dysfunction using TDI score on Sniffin sticks test to be 39.8%. 5,28 These values are much lower than the prevalence of 69.8% found in this study but close to the 68.9% found in the identification component of the TDI score in HIV positive adults in another hospital in southern Nigeria.…”