Oral lesions as predictors of highly active antiretroviral therapy failure in Brazilian HIV-infected children.
OBJECTIVE
Evaluate the accuracy of HIV-related oral lesions to predict immune and virologic failure on HIV-infected children in use of highly active antiretroviral therapy (HAART).


METHODS
Data for this cross-sectional analysis come from a longitudinal study being conducted through the HIV-AIDS Outpatient Unit, ENT Division, Hospital das Clinicas, Sao Paulo University Medical School. The study began in January 1990 and is still ongoing. The cut-off point for analyses purposes was December 2004. Subjects were 471 HIV-infected consecutive children attending the outpatient unit during this period, who enrolled regardless of medical or immunological status. The children have undertaken oral cavity examination, serum CD4(+) T-lymphocyte count, and, 271 of them, viral load measurement. Sensitivity, specificity, positive predictive value, negative predictive value and relative risk were calculated.


RESULTS
Oral lesions had moderate sensitivity, high specificity and positive predictive value to predict immune failure. It had low sensitivity and positive predictive value, and high specificity to predict virologic failure.


CONCLUSIONS
Oral manifestations of HIV can be important markers for immune suppression and for virologic failure, in Brazilian children undergoing HAART.
Miziara
Ivan Dieb
ID
ENT Discipline, Sao Paulo University Medical School - Group of Otorhinolaryngology and AIDS, Sao Paulo, Brazil. miz@uol.com.br
Weber
Raimar
R
D023241:Antiretroviral Therapy, Highly Active / Q000706:statistics & numerical data*; D001938:Brazil; D018791:CD4 Lymphocyte Count; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy*; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D009059:Mouth Diseases / Q000150:complications*; D011379:Prognosis; D011480:Protease Inhibitors / Q000627:therapeutic use; D012307:Risk Factors; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D017211:Treatment Failure; D019562:Viral Load
D011480:Protease Inhibitors