ORAL-DISEASES, MYCOLOGY AND PERIODONTAL MICROBIOLOGY OF HIV-1-INFECTED WOMEN

HIV-1 infection is increasing more rapidly among heterosexual women. R elatively limited information is available on HIV-related oral pathose s in these individuals. To gain insight into the type and occurrence o f oral lesions in this population, 25 HIV-1 infected women including a symptomatic, symptomatic and AIDS patients were examined clinically an d sampled for detection of oral yeast and characterization of their su bgingival microbial flora. Sixty percent of the subjects were African- American, with 80% infected via heterosexual contact. Oral candidiasis was the most common nonperiodontal oral lesion, observed in 44% of th e patients. Oral yeast was cultured from all women with candidiasis an d 76% of the total subjects. Oral hairy leukoplakia was clinically dia gnosed in 16% of the subjects. Clinically mild to moderate gingivitis and periodontitis were observed in 84% and 52% of the patients, respec tively. Candidiasis and the presence of cultivable yeast were observed in patients with low, intermediate, and high CD4(+) T lymphocyte numb ers. Plaque samples were collected from each subject and enumerated by predominant cultivable methods, selective media and microscopy. No di fferences were detected in the microflora associated with seropositive women with existing periodontitis relative to those without periodont itis or to seronegative women with periodontitis. Candidiasis was the most notable oral clinical manifestation in the HIV-l-infected women a nd may be a useful clinical indicator of early immune dysfunction medi ated by HIV-1.