Incidence of oral candidiasis and oral hairy leukoplakia in HIV-infected adults in North Carolina.
OBJECTIVE
To establish incidence rates and risk factors for HIV-associated oral candidiasis (OC), oral hairy leukoplakia (OHL), and any HIV-associated oral diseases (HIV-OD).


METHODS
This prospective, cumulative case-control study followed 283 initially oral disease-free HIV-1-infected men and women for 2 years. Incidence rate ratios (IRR) and incidence proportions for OC, OHL, and HIV-OD were estimated. Multivariable analyses using Poisson regression determined the most parsimonious best-fitting model explaining the outcomes.


RESULTS
Incidence rate (per 1000 person-months) was 9.3 for OC, 6.8 for OHL, and 13.5 for HIV-OD. Incidence of OC was associated with low CD4 count (adjusted IRR = 3.0 (95% CI = 1.7, 5.1)), smoking (IRR = 1.9 (1.0, 3.8)) and combination antiretroviral therapy (IRR = 0.3 (0.1, 0.8)). Incidence of OHL was associated with low CD4 count, conditional upon smoking status. Conclusions Low CD4 count and smoking are important risk factors for HIV-associated OC and OHL. Antiretroviral medications are protective for OC but not for OHL.
Chattopadhyay
Amit
A
Department of Informatics, School of Dentistry, Temple University, Philadelphia, PA, USA.
Caplan
Daniel J
DJ
Slade
Gary D
GD
Shugars
Diane C
DC
Tien
Hsaio-Chuan
HC
Patton
Lauren L
LL
D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology*; D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count; D002180:Candidiasis, Oral / Q000453:epidemiology*; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D017733:Leukoplakia, Hairy / Q000453:epidemiology*; D008297:Male; D015999:Multivariate Analysis; D009657:North Carolina / Q000453:epidemiology; D016012:Poisson Distribution; D011446:Prospective Studies; D012044:Regression Analysis; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology
D019380:Anti-HIV Agents