THE OLFACTORY LOSS THAT ACCOMPANIES AN HIV-INFECTION

A number of studies have shown that HIV infection is associated with d ecreased olfactory ability. Additionally, it has been hypothesized tha t a reduced odorant identification may precede the advent of AIDS Deme ntia Complex (ADC). However, it is not known whether changes in olfact ory ability are a manifestation of neurocognitive decline which may pr ecede the appearance of AIDS Dementia Complex, damage to the periphera l olfactory system from opportunistic infection, or whether olfactory structures have a particular sensitivity to I-W. These issues were add ressed in a cross-sectional study examining variability in the neurops ychological, neurological, otolaryngological, auditory, and olfactory status in HIV-positive subjects. A stepwise regression provided eviden ce that the ability to identify odorants was influenced by age, nasal structure and pathology, neurocognitive ability, and level of AIDS Dem entia Complex. On the other hand, only nasal pathologies accounted for the variability in olfactory thresholds. These data suggest that iden tification and thresholds tests may reflect different olfactory pathol ogies. Additionally, these data suggest at least part of the decline i n olfactory ability accompanying an HN infection may be secondary to n asal pathologies. Because of their rapidly changing neurocognitive sta tus, HIV-positive patients represent an excellent group in which to st udy the determinants of olfactory ability. (C) 1998 Elsevier Science I nc.