Oral lesions among women living with or at risk for HIV infection. HIV Epidemiology Research Study (HERS) Group.
OBJECTIVE
Our objectives were to compare the prevalence of oropharyngeal mucosal lesions among human immunodeficiency virus (HIV) seropositive and demographically similar seronegative women, and to determine the association of oral lesions with immunosuppression, substance abuse, use of medications, and utilization of dental services.


METHODS
Participants in a multicenter, longitudinal cohort study of HIV infection in women were evaluated at baseline by interview, physical examination, and laboratory studies.


RESULTS
Oropharyngeal pathology was found in 40% of seropositive and 23% of seronegative women. Oral candidiasis was identified in 15% of seropositive and 3% of seronegative women. Among seropositive women, history of previous oral candidiasis, lower CD4 lymphocyte counts, and current antibiotic use were associated with oral candidiasis. Hairy leukoplakia was identified in 5% of seropositive women and was significantly associated with lower CD4 lymphocyte counts. Gingival erythema and ulcerative gingivitis were found in 23% of participants overall, but were unrelated to HIV serostatus or CD4 lymphocyte count. Substance abuse, lack of dental care, and African-American race were associated with gingival pathology.


CONCLUSIONS
The high prevalence of oral lesions among HIV seropositive and at-risk seronegative women underscores the need for routine oral examination and targeted treatment of this population.
Department of Medicine, Wayne State University School of Medicine, Detroit, Michigan 48201, USA.
P
P
Schuman
S E
SE
Ohmit
J D
JD
Sobel
K H
KH
Mayer
V
V
Greene
A
A
Rompalo
R S
RS
Klein
D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology* / Q000209:etiology; D018791:CD4 Lymphocyte Count; D003729:Dental Care; D004363:Drug Utilization; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D009059:Mouth Diseases / Q000453:epidemiology* / Q000209:etiology; D015995:Prevalence; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000150:complications