TASTE AND SMELL LOSSES IN HIV-INFECTED PATIENTS

Human immunodeficiency virus (HIV-1) associated wasting is an increasi ngly common clinical manifestation of AIDS. The pathogenesis of wastin g is multifactorial and includes reduced caloric intake as a major con tributing mechanism. The perceptions of taste and smell play an import ant role in stimulating caloric intake and in optimizing nutrient abso rption through cephalic phase reflexes. The purpose of this study was to evaluate the degree of losses in taste and smell function that occu r in subjects infected with HIV. Taste and smell function was evaluate d in 40 HIV infected individuals and 40 healthy control subjects match ed for age, sex, race, smoking behavior, and number of years of educat ion. Chemosensory tests administered to subjects included taste and sm ell detection thresholds, taste and smell memory tests, taste and smel l discrimination rests, and taste and smell identification tasks. Sign ificant differences were observed between experimental and control sub jects in glutamic acid taste detection threshold (p < 0.001), quinine hydrochloride taste detection threshold (p < 0.001), menthol smell det ection threshold (p < 0.001) and in the taste identification task (p = 0.006). Overall the results suggest abnormalities in the peripheral a nd central nervous systems, and subjective distortion of taste and sme ll. A significant correlation was not established between CDC classifi cation of HIV infection and taste and smell function, although trends were observed suggesting worsening function with progression of HIV di sease. These results document significant taste and smell losses in HI V infected subjects which may be of clinical significance in the devel opment or progression of HIV associated wasting.