ORAL LESIONS AMONG HIV-INFECTED HEMOPHILIACS - A STUDY OF 54 PATIENTS

Background. HIV-infected individuals develop a large variety of oral m anifestations. This study was designed to assess the prevalence and ty pes of oral lesions among HIV-positive hemophiliacs. Materials and Met hods. A study population of 54 hemophiliacs was evaluated from Februar y, 1987 to March, 1992 in order to analyze types, prevalence and relat ionships to clinical stages of HIV-related oral lesions. Thirty-six (6 7%) of the group of patients were HIV seropositive. The remaining 18 t ested negative to HN during the observation period. Results. The major ity of patients suffered from hemophilia A. One patient was also bisex ual and two were also intravenous drug. abusers. Analysis of patient s tage revealed that half had a CD4(+) T-lymphocyte count over 0.5 x 10( 9)/L cells, 10 between 0.2 and 0.499 x 10(9)/L and 8 showed a count lo wer than 200 x 10(9)/L. Oral lesions were recorded in 18 (50%) HIV-ser opositive hemophiliacs. No oral lesions were observed among the HIV-se ronegative hemophiliacs. Advanced stage of immunosuppression and prese nce of oral lesions were significantly associated (p=0.040). Candidias is was the most common disturbance, followed by hairy leukoplakia. Ora l herpes simplex infection, necrotizing gingivitis and facial herpes t ester were found in a small number of patients. Those with oral lesion s showed a lower median CD4(+) T lymphocyte count (0.209 x 10(9)/L cel ls; range 0.008 to 0.615) when compared to the ones without oral lesio ns (median CD4(+) count was 0.539 x 10(9)/L cells; range 0.042 to 1.18 0; p=0.002). Conclusions. HIV-seropositive hemophiliacs may develop or al lesions during the course of their disease. Candidiasis and hairy l eukoplakia are among the most common manifestations. A careful oral ex amination should be included in the clinical evaluation of all HIV-inf ected hemophiliacs.