Development of Oral Lesions in Human Immunodeficiency Virus-infected Transfusion Recipients and Hemophiliacs

Abstract

The authors used multivariate repeated-measures transition models to identify risk factors for two oral lesions related to human immunodeficiency virus (HIV)-candidiasis and hairy leukoplakia-in 152 HIV-infected blood transfusion recipients and hemophiliacs. Subjects were examined for occurrences of these lesions every 6 months from July 1985 through March 1993, yielding 1,076 study visits. It was found that, after adjustment for the CD4:CD8 T-lymphocyte ratio, patients with a history of candidiasis in the previous 18 months were at high risk of lesion recurrence. This risk increased with the number of prior episodes and with the recency of the episode(s). A history of hairy leukoplakia was less predictive of persistence of that lesion after adjustment for significant risk factors (including candidiasis and use of antifungal agents at the current examination, a low CD4:CD8 cell ratio, and age less than 40 years). The authors also found a high coprevalence of candidiasis and hairy leukoplakia in these subjects. These results suggest that HIV-infected patients with oral candidiasis should be carefully monitored for subsequent episodes over the next 12-18 months, and patients with either oral candidiasis or hairy leukoplakia and a low CD4:CD8 cell ratio should be carefully examined for the other type of lesion as well.

Co‐existence between oral lesions and opportunistic systemic diseases among HIV‐infected subjects in Thailand

“…This study revealed that oral candidiasis and HL were the two most prevalent types of oral lesion among the patients infected with HIV, as reported in our previous studies (10, 23) and by others (5, 24, 25). Some studies have reported that there is a concurrent association between HL and oral candidiasis of any form (26, 27). Similar findings have also been observed in our study (OR 3.5; 95% CI 2.0–5.8; P < 0.001).…”

“…Similar findings have also been observed in our study (OR 3.5; 95% CI 2.0–5.8; P < 0.001). The high coprevalence of oral candidiasis and HL among the patients suggests that clinicians finding one of these lesions should thoroughly examine the patient for the other (26).…”

Applications of continuous time hidden Markov models to the study of misclassified disease outcomes

“…Furthermore, other oral lesions can be misdiagnosed as HL or co-occur with HL (for example, oral candidiasis) leading to false positive or false negative diagnoses. Although other analyses have investigated risk factors for development and remission of HL [21,3], these have not explicitly accounted for misclassiÿed diagnoses.…”

Prevalence of Oral Manifestations and Their Association with CD4/CD8 Ratio and HIV Viral Load in South India

“…Few studies have evaluated the relationship of CD4/CD8 ratio with oral manifestations [5–8]. High CD8 lymphocytosis and low CD4/CD8 ratio have also been associated with oral candidiasis (OC) [5, 7]. Studies from western countries have also shown association of oral manifestations with higher HIV viral load [9–12].…”