title: HIV-related oral manifestations in two cohorts of women in San Francisco.
abstract: The goals of this study were to compare the prevalence of oral lesions in women infected with human immunodeficiency virus (HIV) and HIV-negative women, and to determine the association of oral lesions with route of HIV transmission and with level of immunosuppression in infected women. As part of a prospective 4-year study, oral examinations and blood tests were performed, at 6-month intervals, on 176 HIV-infected women and on 117 HIV-negative women at risk for HIV infection. We evaluated participants for the following oral conditions: hairy leukoplakia, candidiasis, ulcers, warts, non-Hodgkin's lymphoma, Kaposi's sarcoma, and parotid enlargement. As previously reported in men, the prevalence of oral lesions was significantly higher among HIV-infected (22%) than HIV-negative women (3%) [odds ratio (OR) = 8.2; 95% confidence interval (CI) 2.8, 23.5], particularly candidiasis (14%) and hairy leukoplakia (10%). Among HIV-infected women with CD4 cell count nadir > or = 200 cells/microliters, the prevalence of hairy leukoplakia was higher among those infected heterosexually than among injection drug users (OR = 5.5; 95% CI: 1.5; 19). The OR for the association between oral lesions and CD4 cell count nadir (< 200 vs. > 500 cells/microliters) was 8.9 (95% CI: 2.6, 30), indicating a strong positive association with level of immunosuppression.
authors.affiliation: Department of Stomatology, University of California, San Francisco 94143-0422.
authors.forename: C H
authors.initials: CH
authors.lastname: Shiboski
authors.forename: J F
authors.initials: JF
authors.lastname: Hilton
authors.forename: D
authors.initials: D
authors.lastname: Greenspan
authors.forename: J L
authors.initials: JL
authors.lastname: Westenhouse
authors.forename: P
authors.initials: P
authors.lastname: Derish
authors.forename: K
authors.initials: K
authors.lastname: Vranizan
authors.forename: A R
authors.initials: AR
authors.lastname: Lifson
authors.forename: A
authors.initials: A
authors.lastname: Canchola
authors.forename: M H
authors.initials: MH
authors.lastname: Katz
authors.forename: J B
authors.initials: JB
authors.lastname: Cohen
mesh_terms: D000328:Adult; D015496:CD4-Positive T-Lymphocytes; D002180:Candidiasis, Oral / Q000150:complications / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000276:immunology / Q000635:transmission; D018023:HIV Seronegativity; D006801:Humans; D007108:Immune Tolerance; D007958:Leukocyte Count; D017733:Leukoplakia, Hairy / Q000150:complications / Q000453:epidemiology; D008875:Middle Aged; D009059:Mouth Diseases / Q000150:complications / Q000453:epidemiology*; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D012495:San Francisco / Q000453:epidemiology