SUBCLINICAL HUMAN IMMUNODEFICIENCY VIRUS-RELATED CHANGES IN ORAL-MUCOSA SHOWN BY IMAGE-ANALYSIS OF TONGUE SMEARS

There is evidence that certain lesions of the oral mucosa, such as hai ry leukoplakia (HL), in patients seropositive for human immunodeficien cy virus correlate with the subsequent development of acquired immune deficiency syndrome. The authors suggest that HL is a final manifestat ion of alterations that gradually develop after HIV infection. To reco gnize inapparent early subclinical changes in oral mucosa, the authors applied methods of digital image analysis to investigate tongue smear s from healthy control subjects and immunosuppressed patients after ch emotherapy and HIV infection. Their studies concentrated on nuclear mo rphologic features and chromatin structure. The results obtained with a large set of subvisual parameters indicated significant differences in nuclear and chromatin features between the smear patterns of invest igated groups. One important implication of these studies is that comp uterized image analysis of simply prepared tongue smears enables one t o recognize subvisual HIV-related changes before clinical evidence of HL appears.