The accurate diagnosis of oral lesions in human immunodeficiency virus infection. Impact on medical staging. NLM AIDSLINE Important note: Information in this article was accurate in 1996. The state of the art may have changed since the publication date.

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The accurate diagnosis of oral lesions in human immunodeficiency virus infection. Impact on medical staging.

Arch Otolaryngol Head Neck Surg. 1996 Jan;122(1):68-73. Unique Identifier : AIDSLINE MED/96133394
Cruz GD; Lamster IB; Begg MD; Phelan JA; Gorman JM; el-Sadr W; New York City (NY) Department of Health, USA.

Abstract: OBJECTIVE: To compare identification of oral candidiasis (OC) and oral hairy leukoplakia (OHL) by medical examiners and oral/dental examiners and to assess the impact of these diagnoses on the medical staging of the human immunodeficiency virus (HIV). DESIGN: Retrospective analysis of data collected by medical and oral/dental examiners at the baseline examination of a prospective study. SETTING: Homosexual men and men and women who were parenteral drug users residing in New York City, enrolled in a longitudinal cohort study. SUBJECTS: A total of 245 individuals participated in this study. MAIN OUTCOME MEASURES: The diagnoses of OC and OHL as recorded in the medical and oral/dental charts were analyzed retrospectively for the same medical and oral/dental evaluation visits. The medical staging of HIV infection based on that evaluation was analyzed concomitantly. RESULTS: Among homosexual men, the oral/dental examiners diagnosed OC in 11% of the individuals and the medical examiners in 4%. In the same cohort, OHL was diagnosed by the oral/dental examiners in 14% of the individuals and by the medical examiners in 8%. Among the parenteral drug users the oral/dental examiners diagnosed OC in 29% of the individuals while the medical examiners made this diagnosis in 11%. In the same cohort, OHL was diagnosed by the oral/dental examiners in 9% of the individuals and by the medical examiners in 2%. The OC and OHL diagnoses affected the medical staging of 12% of the HIV-positive homosexual men and of 22% of the HIV-positive parenteral drug users. Forty percent of the HIV-positive homosexual men and 79% of the HIV-positive parenteral drug users with stage-defining oral lesions were not properly identified by the medical examiners. CONCLUSIONS: Specific training and a comprehensive oral examination have a significant impact on the diagnoses of OC and OHL, and on the medical staging of individuals with HIV infection.
Keywords: Candidiasis, Oral/*DIAGNOSIS/VIROLOGY Communicable Diseases Comparative Study Female Human HIV Infections/*COMPLICATIONS Leukoplakia, Hairy/*DIAGNOSIS/VIROLOGY Male *Oral Health Pathology, Oral/EDUCATION Physical Examination/*STANDARDS Retrospective Studies Sensitivity and Specificity Severity of Illness Index Specialties, Medical/EDUCATION Support, Non-U.S. Gov't Support, U.S. Gov't, P.H.S. JOURNAL ARTICLEKWDcandidiasis,oral/KWDdiagnosis/virologycommunicablediseasescomparativestudyfemalehumanhivinfections/KWDcomplicationsleukoplakia,hairy/KWDdiagnosis/virologymaleKWDoralhealthpathology,oral/educationphysicalexamination/KWDstandardsretrospectivestudiessensitivityandspecificityseverityofillnessindexspecialties,medical/educationsupport,non-uKWDsKWDgov'tsupport,uKWDsKWDgov't,pKWDhKWDsKWDjournalarticle
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M9651101

Copyright © 1996 - National Library of Medicine. Reproduced under license with the National Library of Medicine, Bethesda, MD.

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