Correlation of oral disease with the Walter Reed staging scheme for HIV-1-seropositive patients.
This study correlates the prevalent oral disease findings in 390 patients seropositive for human immunodeficiency virus type 1 (HIV-1) with their level of staging (Walter Reed) and depletion of peripheral helper T lymphocytes (CD4+). Chronic lymphadenopathy of the head and neck was a common finding (59.2%) that occurred early in staging progression and did not correlate with depression of helper T-cell levels. Of the three prevalent oral disease findings (oral hairy leukoplakia (OHL), candidiasis, necrotizing ulcerative gingivitis [NUG]) only OHL and NUG were significantly correlated with helper T-cell depletion. The occurrence of visually detectable OHL and NUG corresponds to depletion of peripheral helper T-lymphocyte values in a range of 157 to 299 cells/mm3. This range may represent a more accurate value for biologically significant lymphocyte depletion than the Walter Reed value of 400 cells/mm3. The presence of OHL showed a weak statistical correlation with staging progression, indicating deteriorating immunoregulation. No cases of Kaposi's sarcoma or other HIV-1-associated oral diseases were observed in the sample population, regardless of the patient's staging category or peripheral helper T-lymphocyte count.
Thompson
S H
SH
Oral Pathology Service, DENTAC, Tripler Army Medical Center, Honolulu.
Charles
G A
GA
Craig
D B
DB
D000328:Adult; D002180:Candidiasis, Oral / Q000097:blood / Q000150:complications* / Q000175:diagnosis; D016009:Chi-Square Distribution; D005260:Female; D005892:Gingivitis, Necrotizing Ulcerative / Q000097:blood / Q000150:complications* / Q000175:diagnosis; D015483:HIV Antibodies / Q000097:blood; D006679:HIV Seropositivity / Q000150:complications* / Q000175:diagnosis / Q000208:ethnology; D015497:HIV-1 / Q000276:immunology*; D006801:Humans; D007972:Leukoplakia, Oral / Q000097:blood / Q000150:complications* / Q000175:diagnosis; D008231:Lymphopenia / Q000175:diagnosis; D008297:Male; D008889:Military Personnel; D006377:T-Lymphocytes, Helper-Inducer
D015483:HIV Antibodies