HIV‐associated oral lesions; immunologic, virologic and salivary parameters

Abstract

Barr CE, Lopez MR, Rua-Dobles A. Miller LK, Mathur-Wagh U, Turgeon LR: HIV-associated oral lesions: immunologic, virologic and salivary parameters. J Oral Pathol Med 1992; 21: 295-8.There are nutnerous reports of oral lesions in HIV-infected individuals. However, few correlate the oral lesious with laboratory parameters. This study examined oral candidiasis and hairy leukoplakia, the two most cotntnon HIV-associated oral lesions, in relation to T-ccll counts, p24 core antigen levels and salivary fiow rates. Oral muco.sal exatninations. immunologic and virologic studies and stimulated whole and parotid saliva flow rates were conducted on 135 (HIV-f = 102, HIV-=33) homosexual or bisexual men. Results indicate that, among HIVinfected subjects, the odds of having oral caudidiasis is 6 times (95% Cl = 0.6-56.6) greater for subjects with T4 counts between 200-399 per mm', and 23 times (95% CI = 2.8-193.0) greater for subjects with T4 counts less than 200/ mrn' compared to subjects with T4 counts of 400/tntTt' or greater. Subjects had an equal likelihood of having hairy leukoplakia at different levels of itnimunocompetencc. The prevalence of oral candidiasis and hairy leukoplakia was higher among subjects with itifcctious virus in their serum, but was only statistically significant for hairy leukoplakia (p = 0.0\).

Oral diseases in HIV-1 infection

“…Large necrotizing ulcers of unknown origin have been reported in HIV-positivc subjects [63,64]. This author has personally d o c u m e n t e d five cases (although they are not reported in the literature).…”

“…While these various forms of Candida albicans may present different clinical manifestations there is no compelling scientific evidence that one type is more predictive of i m m u n e status than any o f the In a recent report [20] it was demonstrated that the presence of oral candidiasis may not only be predictive of immunosuppression but that its appearance may be highly associated with absolute numbers o f T 4 cells. The report concluded that compared with H I V + individuals with over 400 T4 cells per m m 3 the odds ratio for contracting oral candidiasis is seven times greater for those with between 399 and 200 T4 cells per m m 3, and 23 times greater when T4 cells fall below 200/ram 3.…”

“…One study, where a homosexual/ bisexual cohort was followed every 4 m o n t h s for over 24 months, noted that while up to 20% had O H L at baseline, the appearance of the lesion had no statistically significant association with specific stages of the disease, including T4-cell levels, or with those who develop the more advanced stage of A I D S (opportunistic diseases, cytomegaloviral retinitis, Mycohacterium avium-intracellulare) [20].…”

Manifestações orais associadas ao HIV após 30 anos de epidemia no Brasil

“…De acordo com descrito na literatura, a presença de lesões orais esteve associada a CD4 <200 (p=0,002) (Barr et al, 1992;Glick et al, 1994;Patton et al, 2000;Ramírez-Amador et al, 2003;Kerdpon el al., 2004;Sharma et al, 2009;Ferreira et al, 2009) e CV >10.000 (p=0,05) Ramírez-Amador et al, 2003;Ferreira et al, 2007). Porém, quando se analisa a presença de lesões orais em outras faixas de CV em log, apesar de estarem mais presentes em pacientes com CV acima de 100.000 (log5), não houve significância estatística (p=0,06).…”

“…Barr et al (1992) encontraram resultados semelhantes para a CO e CD4<200 (p=0,0001), porém não relacionaram a variável com a LP (p=0,60). As médias de CD4 para a CP (156), CE (182) e QA (62), também estavam abaixo de 200.…”