Oral Lesions: Poor Markers of Virologic Failure in HIV-Infected Patients on Antiretroviral Therapy

Abstract

e objective of this study was to assess the use of HIV-oral lesions (OLs) as markers of virologic failure (VF) in response to antiretroviral therapy (ART). Concurrent virologic status was compared between 744 individuals with and without OL ( 2 ). Time to VF between OL groups was compared (Kaplan-Meier), and baseline factors associated with VF were determined (Cox Hazard models). Sensitivity, speci�city, positive predictive value, and negative predictive value were also computed. At baseline and 12 months, individuals with OL were more likely to have viral load ≥ 10, 000 copies/ml compared to patients without OL ( 0 01). Time to VF between patients with baseline OL (mean: 17 months, 95% CI 16-18) and patients without baseline OL (mean: 19 months, 95% CI: 18-20) was statistically different. Patients who were African-American (HR 1.356; 95% CI: 1.045-0.759), ARTexperienced (HR 2.298; 95% CI: 1.743-3.030), had mental disorders (HR 1.410; 95% CI: 1.078-1.843), and had high baseline viral load (HR 2.82; 95% CI: 1.661-3.137), were more likely to have VF a�er the �rst six months of ART. OL had a moderate positive predictive value for concurrent VF at 6 months (45.5%) and 18 months (33.3%), but a strong positive predictive value at 12 months (80.0%) and 24 months (100.0%). Findings of this study suggest that OLs could be poor predictors of VF in HIV-infected patients on ART therapy.

Profil comparatif et évolutif des personnes infectées par le virus de l’immunodéficience humaine traitées aux antirétroviraux à Kinshasa, République Démocratique du Congo

“…La présence des lésions des muqueuses buccales contribue à la diminution des apports alimentaires par l'anorexie, un des plus importants facteurs de risque clinique de la malnutrition [ 24 ]. Et la persistance de certaines lésions des muqueuses notamment la candidose buccale sont associées avec un échec immunologique et une progression du sida [ 25 ].…”