Release: May 9, 1998 Contact: Kenneth Satterfield
(703) 519-1563
email: [email protected]
In Palm Beach, FL (5/9-5/16)
(561) 653-6332
TWO MEDICAL RESEARCH STUDIES EXAMINE TREATMENT OPTIONS FOR RHINITIS IN HIV-INFECTED PATIENTS Rhinitis is a significant health problem for the HIV-infected population. Two studies being presented at a national medical society meeting explore the effectiveness of new treatments.
PALM BEACH, FL -- Medical evidence has shown that chronic rhinitis in HIV-infected individuals is a recurrent and persistent condition with potentially serious complications. The disease takes its toll through long term and frustrating daily symptoms which include facial pain, nasal congestion, and chronic discharge from the nasal mucous membrane. Some medical studies have suggested that sinonasal disease must be considered as a possible cause of olfactory dysfunction, or the loss of the sense of smell.
Conventional treatments administered to HIV-infected patients have generally been ineffective. Two new medical research studies have examined how the affected population responds to new treatments. The studies are, "The Impact of Nasal Steroids on Olfactory Function in Patients Infected with HIV," and "Ipratropium Bromide Nasal Spray Treatment of Chronic Rhinitis in HIV-Infected Patients." The former was authored by Joel Anthus, MD, and David Darrow, MD, both from the Eastern Virginia Medical School and Children's Hospital of the King's Daughters, Norfolk, VA; the latter research study was the joint effort of Todd G. Broberg, MD, Andrew Murr, MD, and Kelvin Lee, MD, all three from the University of California-San Francisco.
The results of the two studies were presented before a meeting of the American Rhinologic Society. The organization is currently meeting at a gathering of ten ear, nose, and throat societies being held May 9-16, 1998, at the Breakers Hotel, Palm Beach, FL, coordinated by the American Academy of Otolaryngology--Head and Neck Surgery Foundation.
The Impact of Nasal Steroids on Olfactory Function in Patients Infected with HIV: This research effort, carried out in Norfolk, VA, was performed to test whether nasal steroids used in HIV infected patients, presumed to be at high risk for allergic rhinitis and sinusitis, would improve their sense of smell.
Methodology: A double blind, two week trial of steroid nasal spray versus placebo nasal spray was administered to 51 subjects, recruited from the outpatient infectious disease clinic at the Eastern Virginia Medical School. Of the group, 37 completed the study; 22 using the steroid nasal spray; 15, used the placebo spray. Subjects on antibiotics for other reasons were dismissed from the study; those taking conventional rhinitis treatments underwent a four week "washout period."
After the trial period, each subject completed a questionnaire, was given an olfactory test, and as a last step, provided a completed ear, nose, and throat examination including a nasal cytogram, a test to determine the presence of allergic rhinitis or sinonasal inflammation.
Results: In the study, the researchers found that subjects with a diminished sense of smell and using nasal steroids, increased olfactory function; those who using the placebo had further deterioration of their sense of smell. The study also suggested a possible correlation between blood levels of HIV and impaired sense of smell. The authors recommend a larger study to prove statistical significance in their results.
Ipratropium Bromide Nasal Spray Treatment of Chronic Rhinitis in HIV-Infected Patients: The authors found that Ipratropium bromide (Atrovent) nasal spray has been shown to be effective with patients able to mount a normal immune response. Accordingly, their research was a pilot study to determine the effects of the nasal spray on patients known to HIV positive and who have chronic rhinitis.
Methodology: Nine HIV-positive men, age 35-55, all with chronic rhinitis resistant to other treatments were enrolled in the study. All of the patients were symptomatic when joining the study. The patients were seen during three monthly evaluation periods. Questionnaires, physical examinations were completed; each were treated with 0.06% Ipratropium bromide spray. After receiving the treatment for one month, they were removed from treatment for another month.
Results: Anecdotal findings included a conclusion that the use of Ipratropium bromide can control rhinitis symptoms in select patients. Those responding to the treatment were subjects who clear nasal discharge and nasal congestion. Those with green secretions, opacified sinuses, or dryness, may respond poorly to the spray.
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Editors Note: Reporters interested in interviewing the presenters and/or obtaining additional information regarding the medical research should contact Ken Satterfield, Media Relations Director, American Academy of Otolaryngology--Head and Neck Surgery, at (703) 519-1563 (prior to May 8); or at COSM (through May 14), phone (561) 653-6332.
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