Ar. Lifson et al., TIME FROM HIV SEROCONVERSION TO ORAL CANDIDIASIS OR HAIRY LEUKOPLAKIAAMONG HOMOSEXUAL AND BISEXUAL MEN ENROLLED IN 3 PROSPECTIVE COHORTS, AIDS, 8(1), 1994, pp. 73-79
Objectives: We evaluated time from HIV seroconversion to diagnosis of
two common oral lesions associated with HIV infection and disease prog
ression. Design: Oral examinations were performed on homosexual and bi
sexual men enrolled in prospective cohorts. Setting: Homosexual and bi
sexual men were followed in three epidemiologic cohort studies in San
Francisco, California, USA. Participants: Data were evaluated from 80
men with well-defined dates of HIV seroconversion from 1984 through 19
91. Main outcome measures: We determined the cumulative incidence of o
ral candidiasis and hairy leukoplakia after HIV seroconversion. Result
s: Four per cent of men developed oral candidiasis within 1 year after
HIV seroconversion, 8% within 2, 15% within 3, 18% within 4, and 26%
within 5 years. Nine per cent developed hairy leukoplakia within 1 yea
r, 16% within 2, 25% within 3, 35% within 4, and 42% within 5 years. T
he median CD4+ count was 391 x 10(6)/l when oral candidiasis was first
reported and 468 x 10(6)/l when hairy leukoplakia was first reported.
Conclusions: Oral candidiasis or hairy leukoplakia appeared in a sign
ificant proportion of HIV-infected homosexual and bisexual men. These
lesions occurred relatively soon after HIV seroconversion, typically b
efore AIDS. Evaluation of HIV-infected individuals for these lesions h
as many potential clinical and research benefits, including the possib
le use of oral lesions as primary end-points in clinical trials.