Am J Psychiatry 1991; 148:248-250
Copyright © 1991 by American Psychiatric Association
Olfactory identification deficits in HIV infection
D Brody, M Serby, N Etienne and DS Kalkstein
Department of Psychiatry, New York University School of Medicine, New York VA Medical Center, NY.
OBJECTIVE: Impaired odor identification is described in a number of CNS
disorders, and human immunodeficiency virus (HIV) infects the CNS in a
large percentage of patients. To evaluate whether impaired olfaction may
indicate CNS disease, the authors measured odor identification in patient
groups defined along a continuum of progressive immunodeficiency and in a
comparison group. METHOD: Most of the 42 HIV- infected patients in the
study were outpatients in a clinic specializing in treatment of
HIV-infected individuals. The comparison subjects were 37 healthy age- and
sex-matched individuals who were recruited from hospital and medical school
personnel. Ten of the patients were HIV-seropositive but had no symptoms,
24 had clinical evidence of immunocompromise, and eight had HIV dementia.
All subjects were given the University of Pennsylvania Smell Identification
Test, which presents common odorants and requires the subject to identify
the odor from a four-item word list. The data were analyzed by using
analysis of variance after arc-sine transformation and Scheffe post hoc
analysis. RESULTS: All patients scored significantly lower on the Smell
Identification Test than did the comparison subjects. The patients with HIV
dementia had significantly lower scores than did the other two groups of
patients. CONCLUSIONS: Clinically, impaired olfaction might serve as a
marker of early CNS HIV involvement. Future studies should attempt to match
comparison and experimental populations for socioeconomic status and HIV
risk behavior.
