title: Longitudinal study of the prevalence and prognostic implications of oral manifestations in romanian children infected with human immunodeficiency virus type 1.
abstract: OBJECTIVE
  We evaluated the prevalence and predictive value for human immunodeficiency virus (HIV) disease progression of oral manifestations in Romanian children.
  
  
  METHODS
  A nonrandom sample of 238 HIV-infected children was followed prospectively between 1998 and 2001 at the Romanian-American Children's Center in Constanta, Romania. Study subjects underwent comprehensive annual oral examinations. Oral manifestations of interest, demographic data and other selected medical information were recorded at baseline and at each subsequent visit. Descriptive statistics and survival analysis methods were used in the study. A level of statistical significance of alpha = 0.05 was used.
  
  
  RESULTS
  The study subjects' mean age was 9.9 +/- 1.2 (SD) years. The most common oral lesions were gingivitis (49%), parotid enlargement (13%) and oral candidiasis (11%). Oral candidiasis was associated with progression to acquired immunodeficiency syndrome or death (whichever occurred first) (log rank P = 0.03) and with death (log rank P < 0.001). Oral hairy leukoplakia also was associated with progression to death (log rank P = 0.001). The risk of dying was 3.43 (95% confidence interval, 1.86-6.34; P < 0.001) for children who had oral candidiasis at baseline and 4.62 (95% confidence interval, 1.67-12.77; P = 0.003) for those who had oral hairy leukoplakia.
  
  
  CONCLUSIONS
  Oral manifestations occur commonly among HIV-infected Romanian children. Oral candidiasis and oral hairy leukoplakia were positive predictors of HIV disease progression.
authors.affiliation: Romanian-American Children's Center, Constanta, Romania.
authors.forename: Nicoleta
authors.initials: N
authors.lastname: Vaseliu
authors.forename: A Bruce
authors.initials: AB
authors.lastname: Carter
authors.forename: Nancy E
authors.initials: NE
authors.lastname: Kline
authors.forename: Claudia
authors.initials: C
authors.lastname: Kozinetz
authors.forename: Stanley G
authors.initials: SG
authors.lastname: Cron
authors.forename: Rodica
authors.initials: R
authors.lastname: Matusa
authors.forename: Mark W
authors.initials: MW
authors.lastname: Kline
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology / Q000209:etiology / Q000401:mortality; D000293:Adolescent; D002180:Candidiasis, Oral / Q000453:epidemiology / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D005260:Female; D005891:Gingivitis / Q000453:epidemiology / Q000209:etiology; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology / Q000401:mortality / Q000503:physiopathology; D015497:HIV-1; D006801:Humans; D017733:Leukoplakia, Hairy / Q000453:epidemiology / Q000209:etiology; D008137:Longitudinal Studies; D008297:Male; D009059:Mouth Diseases / Q000453:epidemiology / Q000209:etiology / Q000401:mortality; D010305:Parotid Diseases / Q000453:epidemiology / Q000209:etiology; D012383:Romania / Q000453:epidemiology; D016019:Survival Analysis