THE RELATIONSHIP OF ORAL MANIFESTATIONS TO PARAMETERS OF IMMUNE FUNCTION AND CDC STAGE IN CHILDREN BORN TO HIV-POSITIVE WOMEN

A review of hospital records at the Hospital for Sick Children, Toront o, Ontario, Canada was undertaken for children who were born to HIV-in fected women and referred to the Hospital for Sick Children between Oc tober 1988 and September 1992. The results of clinical and laboratory examinations for this period were collected and analyzed. Statistical methods included analysis of variance and linear regression. Hospital records for 33 children were reviewed. The mean age for the children a t the start of the study was 17 months (range 1-99 months). At the beg inning of the review period, 16 were confirmed HIV-positive (P1 or P2) and 17 were indeterminant (P0). At the end of the review period, 4 ch ildren were PO, 5 were P1, 10 were P2, 12 were confirmed not infected, and 2 children were deceased. The frequency and severity of oro-facia l manifestations were recorded and their presence correlated with labo ratory measures of immunologic function. The results show that the mos t prevalent oro-facial manifestations in this cohort were cervical lym phadenopathy and oral candidiasis. There was no statistical associatio n between cervical lymphadenopathy and Centers for Disease Control and Prevention (CDC) staging. However, cervical lymphadenopathy was stati stically significantly related to an increase in serum IgG and a decli ne in CD+ T-cells in HIV-infected children. Oral candidiasis was signi ficantly associated with a decline in the absolute number of CD4+ T-ce lls, and an increase in the level of serum IgG and was much more preva lent in children with symptomatic HIV disease. We conclude that oral c andidiasis is a common manifestation of HIV disease in children infect ed perinatally and that its presence signals increasing immunosuppress ion.