title: HIV-related oral lesions, demographic factors, clinical staging and anti-retroviral use.
abstract: BACKGROUND
  The aim of the present study was to compare the prevalence of HIV-related oral lesions (HIV-OL) between two health centers for HIV in Mexico City and to analyze the factors that, in addition to combined antiretroviral therapy (CART) and low CD4(+), may be associated with possible differences in prevalence.
  
  
  METHODS
  A cross-sectional observational study was performed between January 2000 and February 2003 at the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), a specialized referral center for HIV/AIDS patients and the Clínica Especializada Condesa (CEC), a primary care center for HIV-infected individuals without social security insurance. A consecutive sample of HIV-infected individuals had an oral examination based on established clinical criteria. Demographic, clinical and laboratory data were obtained. Independent association of each factor with specific HIV-OL was assessed by logistic regression modeling.
  
  
  RESULTS
  Eight hundred fifty individuals were examined (INCMNSZ: 479; CEC: 371). Hairy leukoplakia (HL), periodontal disease (PD) and Kaposi's sarcoma (KS) were independently associated with the study site [odds ratio (OR) = 1.7 (95% confidence interval (CI): 1.1-2.4), OR = 4.2 (95% CI: 1.3-13), OR = 10.1 (95% CI: 2.7-38.2), respectively], being more frequent in CEC patients. HL was independently associated with men having sex with men OR = 1.7 (95% CI: 1.1-2.8). All HIV-OL were independently associated with CD4(+) counts and, with the exception of PD and KS, with time under CART.
  
  
  CONCLUSIONS
  The present comparative study showed that several factors were associated with a difference in prevalence of oral lesions found in two AIDS clinics located in Mexico City. Severe immune suppression, CART duration and the study site were associated with HIV-OL. Further investigation into factors such as socioeconomic determinants associated with HIV-OL is warranted.
authors.affiliation: Universidad Autónoma Metropolitana-Xochimilco, México D.F., México. rava1863@correo.xoc.uam.mx
authors.forename: Velia
authors.initials: V
authors.lastname: Ramírez-Amador
authors.forename: Gabriela
authors.initials: G
authors.lastname: Anaya-Saavedra
authors.forename: Juan J
authors.initials: JJ
authors.lastname: Calva
authors.forename: Tirso
authors.initials: T
authors.lastname: Clemades-Pérez-de-Corcho
authors.forename: Carlos
authors.initials: C
authors.lastname: López-Martínez
authors.forename: Imelda
authors.initials: I
authors.lastname: González-Ramírez
authors.forename: Juan
authors.initials: J
authors.lastname: Sierra-Madero
mesh_terms: D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000150:complications* / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D017733:Leukoplakia, Hairy / Q000097:blood / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D008800:Mexico; D010510:Periodontal Diseases / Q000097:blood / Q000453:epidemiology / Q000209:etiology*; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D012514:Sarcoma, Kaposi / Q000097:blood / Q000453:epidemiology / Q000209:etiology*; D012959:Socioeconomic Factors
chemical_list: D044966:Anti-Retroviral Agents