ORAL EXAMINATION - A SCREENING TOOL FOR HIV-INFECTION

Objective: To estimate the predictive values for HIV infection of diag nosis of oral manifestations of the infection. Method: Prevalence of o ral manifestations was compared in cross sectional blinded clinical ex aminations of homosexual men attending a genitourinary medicine clinic . Data were extrapolated to populations in England and Wales based on estimates of the prevalence of HIV infection. Results: Data were analy sed for 572 HIV infected and non-infected men (312 and 260 respectivel y). Positive predictive values for erythematous candidiasis, hairy leu coplakia and pseudomembranous candidiasis were greater than 0.96 at th e genitourinary medicine clinic and are estimated to be greater than 0 .72 among homosexual men in London. Conclusions: Clinical diagnoses of mucosal lesions alone are poor predictors of HIV infection but are us eful when used in conjunction with a social history to establish if th ere are risk factors for infection.