title: Human immunodeficiency virus-related oral manifestations and gender. A longitudinal analysis. The University of California, San Francisco Oral AIDS Center Epidemiology Collaborative Group.
abstract: BACKGROUND
  Because human immunodeficiency virus (HIV) infection affects an increasing number of women in the United States, we investigated the role played by gender in the occurrence of HIV-related oral conditions.
  
  
  METHODS
  As part of a 4-year prospective study of 3 epidemiological cohorts, oral and physical examinations (including blood tests) were performed on HIV-infected men (n = 200) and women (n = 218) at 6-month intervals. Our outcome variables included oral conditions commonly associated with HIV infection: hairy leukoplakia, candidiasis, ulcers, warts, non-Hodgkin lymphoma, Kaposi sarcoma, and parotid enlargement.
  
  
  RESULTS
  Only hairy leukoplakia, candidiasis, and ulcers were observed. The occurrence of hairy leukoplakia and candidiasis was higher in men (22% and 24%, respectively) than in women (9% and 13%, respectively) during the study period. A regression model for longitudinal data (generalized estimating equation) disclosed that the odds of having hairy leukoplakia were 2.5 times higher for men than for women, after controlling for CD4+ cell count, race, and injecting drug use (95% confidence interval, 1.34-4.76; P = .003). Length of follow-up did not confound this association. A weaker association was found between the occurrence of oral candidiasis and gender (adjusted odds ratio, 1.85; 95% confidence interval, 1.0-3.43; P = .05).
  
  
  CONCLUSIONS
  In this sample of HIV-infected adults, we found that men were significantly more likely to have hairy leukoplakia than were women. The hairy leukoplakia-gender association merits further investigation, because it may be related to a gender difference in the mode of expression of Epstein-Barr virus.
authors.affiliation: Department of Stomatology, University of California, San Francisco, USA.
authors.forename: C H
authors.initials: CH
authors.lastname: Shiboski
authors.forename: J F
authors.initials: JF
authors.lastname: Hilton
authors.forename: J M
authors.initials: JM
authors.lastname: Neuhaus
authors.forename: A
authors.initials: A
authors.lastname: Canchola
authors.forename: D
authors.initials: D
authors.lastname: Greenspan
mesh_terms: D000328:Adult; D002180:Candidiasis, Oral / Q000209:etiology; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D017733:Leukoplakia, Hairy / Q000209:etiology*; D008137:Longitudinal Studies; D008297:Male; D016017:Odds Ratio; D019226:Oral Ulcer / Q000209:etiology; D012307:Risk Factors; D012737:Sex Factors