Oral manifestations associated with HIV-related disease as markers for immune suppression and AIDS.
BACKGROUND
Oral lesions are common findings in HIV-related disease, but little is known about their significance in predicting immune suppression among a representative group of HIV-infected persons.


METHODS
Oral examinations were performed on 454 patients who came to an outpatient dental clinic for dental care. CD4+ cell counts were obtained within 2 months of the examination.


RESULTS
In persons with a specific lesion and a CD4+ cell count below 200 cells/mm3 the corresponding mean CD4+ cell counts and predictive values were 149.5 cells/mm3 and 69.9% for candidiasis, 143.3 cells/mm3 and 70.1% for oral hairy leukoplakia, 126.0 cells/mm3 and 69.4% for xerostomia, 51.8 cells/mm3 and 95.1% for necrotizing ulcerative periodontitis, 98.7 cells/mm3 and 87.0% for long-standing herpes simplex virus infections, 66.6 cells/mm3 and 93.6% for Kaposi's sarcoma, and 33.7 cells/mm3 and 100% for major aphthous ulcers. The mean CD4+ cell count declined with increased numbers of different concurrent lesions.


CONCLUSIONS
The presence of specific oral manifestations and the number of different concurrent intraoral lesions among HIV-infected persons are associated with severe immune suppression and AIDS. Oral examinations are an essential component for early recognition of disease progression and comprehensive evaluation of HIV-infected patients.
Temple University School of Dentistry, Philadelphia, Pa.
M
M
Glick
B C
BC
Muzyka
D
D
Lurie
L M
LM
Salkin
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000276:immunology; D000328:Adult; D015415:Biomarkers; D016516:CD4-CD8 Ratio; D002180:Candidiasis, Oral / Q000209:etiology / Q000276:immunology; D005260:Female; D005892:Gingivitis, Necrotizing Ulcerative / Q000209:etiology / Q000276:immunology; D015658:HIV Infections / Q000097:blood / Q000150:complications / Q000276:immunology*; D006801:Humans; D016867:Immunocompromised Host / Q000276:immunology*; D017733:Leukoplakia, Hairy / Q000209:etiology / Q000276:immunology; D008297:Male; D009059:Mouth Diseases / Q000097:blood / Q000209:etiology / Q000276:immunology*; D016017:Odds Ratio; D011237:Predictive Value of Tests; D015995:Prevalence; D012514:Sarcoma, Kaposi / Q000209:etiology / Q000276:immunology; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013281:Stomatitis, Aphthous / Q000209:etiology / Q000276:immunology; D013283:Stomatitis, Herpetic / Q000209:etiology / Q000276:immunology
D015415:Biomarkers