HIV-RELATED ORAL MANIFESTATIONS IN 2 COHORTS OF WOMEN IN SAN-FRANCISCO

The goals of this study were to compare the prevalence of oral lesions in women infected with human immunodeficiency virus (HIV) and HIV-neg ative women, and to determine the association of oral lesions with rou te of HIV transmission and with level of immunosuppression in infected women. As part of a prospective 4-year study, oral examinations and b lood tests were performed, at 6-month intervals, on 176 HIV-infected w omen and on 117 HIV-negative women at risk for HIV infection, We evalu ated participants for the following oral conditions: hairy leukoplakia , candidiasis, ulcers, warts, non-Hodgkin's lymphoma, Kaposi's sarcoma , and parotid enlargement. As previously reported in men, the prevalen ce of oral lesions was significantly higher among HIV-infected (22%) t han HIV-negative women (3%) [odds ratio (OR) = 8.2; 95% confidence int erval (CI) 2.8, 23.5], particularly candidiasis (14%) and hairy leukop lakia (10%). Among HIV-infected women with CD4 cell count nadir greate r than or equal to 200 cells/mu l, the prevalence of hairy leukoplakia was higher among those infected heterosexually than among injection d rug users (OR = 5.5; 95% CI: 1.5; 19). The OR for the association betw een oral lesions and CD4 cell count nadir (<200 vs. >500 cells/mu l) w as 8.9 (95% CI: 2.6, 30), indicating a strong positive association wit h level of immunosuppression.