ORAL MANIFESTATIONS OF HIV-INFECTION IN HOMOSEXUAL MEN AND INTRAVENOUS-DRUG-USERS - STUDY DESIGN AND RELATIONSHIP OF EPIDEMIOLOGIC, CLINICAL, AND IMMUNOLOGICAL PARAMETERS TO ORAL LESIONS

This article describes the baseline findings from a study designed to compare the oral manifestations of HIV infection in homosexual men and intravenous drug users. Both seropositive and seronegative persons we re studied. A standard examination instrument was developed to record indexes of oral disease as well as to record the presence of oral lesi ons. The two groups differed in terms of education, race, socioeconomi c status, employment status, housing, and smoking experience. The prev alence and type of oral lesions differed in the two seropositive group s. In seropositive homosexual men, white lesions on the tongue (28.4%) predominated; whereas for the seropositive intravenous drug users, or al candidiasis (43.0%) and gingival marginal erythema (33.3%) were mos t often detected. We also observed that seronegative intravenous drug users displayed a greater number of oral lesions than seronegative hom osexual men. For seropositive homosexual men, lesion presence was sign ificantly associated with decreased levels of CD4; positive associatio ns were seen with current smoking, antiviral drug use, and antibiotic use, and a negative association was observed with current employment. In contrast, only exposure to antiviral drugs was significantly correl ated with lesion presence for seropositive intravenous drug users. Thi s baseline analysis from our longitudinal study suggests clear differe nces in oral manifestations of HIV infection between seropositive homo sexual men and intravenous drug users and between seronegative homosex ual men and intravenous drug users. Among other parameters, it is appa rent that lifestyle, access to health care, and the condition of the o ral cavity before infection influence the development of oral lesions in persons with HIV infection.