title: Predictive value of oral candidiasis as a marker of progression to AIDS.
abstract: OBJECTIVE
  To determine the validity of oral candidiasis (OC) as a clinical marker of progression in patients with human immunodeficiency virus infection.
  
  
  METHODS
  In 1992, an oral examination was carried out on a group of 200 HIV-infected patients with a mean age of 36.8 +/- 7 years (range 25-46 years) to establish the diagnosis of OC. The following variables were recorded: age, sex, duration of the disease, risk behaviour, CD4 lymphocyte count, clinical stage and antiretroviral treatment. Of the 200 patients in the group evaluated, 157 did not fulfil the criteria for AIDS at the time of the baseline examination; these patients constitute the study group and underwent 6-monthly follow-up until they fulfilled these criteria. The study was concluded at the end of 2001.
  
  
  RESULTS
  Of the 157 patients selected, 71 (45.2%) did not present OC and, of these, 28.7% progressed to AIDS during the followup period. Of the 86 (54.8%) patients with OC, 48.2% progressed to AIDS (RR= 2.71). If the start date of the study was taken as 1997, when highly active antiretroviral therapy (HAART) was introduced, no differences were found in the percentage of patients who progressed to AIDS with respect to the presence or absence of OC at the baseline examination. Multivariate analysis demonstrated that the association of the presence of OC with progression to AIDS did not reach a predictive value.
  
  
  CONCLUSIONS
  The long-term prognostic value of OC has not been established in patients receiving highly active antiretroviral therapy (HAART). The immunological recovery and the reduction in the number of opportunistic diseases observed after the administration of HAART means that many patients who developed AIDS do not currently satisfy these criteria, making a review of the definition of the syndrome itself a necessity in order to be able to evaluate prognostic markers.
authors.affiliation: Dpto. de Estomatología, Facultad de Medicina y Odontología, Universidad de Santiago de Compostela, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Fernández-Feijoo
authors.forename: Pedro
authors.initials: P
authors.lastname: Diz-Dios
authors.forename: Xosé Luis
authors.initials: XL
authors.lastname: Otero-Cepeda
authors.forename: Jacobo
authors.initials: J
authors.lastname: Limeres-Posse
authors.forename: Javier
authors.initials: J
authors.lastname: de la Fuente-Aguado
authors.forename: Antonio
authors.initials: A
authors.lastname: Ocampo-Hermida
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000328:Adult; D002180:Candidiasis, Oral / Q000453:epidemiology / Q000209:etiology*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012306:Risk