Effect of receptive oral sex and smoking on the incidence of hairy leukoplakia in HIV-positive gay men.
We sought to determine whether hairy leukoplakia (HL), an Epstein-Barr virus-related oral lesion, is associated with receptive oral sex activity and cigarette smoking among HIV-positive gay men. Oral examinations were conducted every 6 months among San Francisco Men's Health Study participants over a 6-year period. We fitted time-to-lesion regression models to compare the incidence of HL among men who had mouth-to-penis contact with various numbers of partners, while controlling for cigarette smoking and CD4 count. The 6-year incidence of HL was 32% among 291 HIV-positive men. We found no significant increase in the hazard of developing HL for each additional insertive-oral-sex male partner in the past 6 months (relative hazard = 1.01; 95% confidence interval [CI], 0.99, 1.02), and a similar lack of association when number of sex partners was categorized. However, the hazard of developing HL doubled with any 300-unit decrease in CD4 count (95% CI, 1.4, 2.7), or if men smoked > or =20 cigarettes/day compared with nonsmokers (95% CI, 1.2, 3.9). This finding, which may suggest one effect that smoking produces on the oral mucosa's local immune response, merits further investigation.
Oral AIDS Center, Department of Stomatology, University of California, San Francisco, 94143-0422, USA. caro@nanook.ucsf.edu
C H
CH
Shiboski
J M
JM
Neuhaus
D
D
Greenspan
J S
JS
Greenspan
D000328:Adult; D005500:Follow-Up Studies; D006679:HIV Seropositivity / Q000150:complications*; D018451:Homosexuality, Male; D006801:Humans; D015994:Incidence; D017733:Leukoplakia, Hairy / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009055:Mouth / Q000473:pathology; D015995:Prevalence; D012725:Sexual Behavior; D012907:Smoking / Q000009:adverse effects*