Oral candidiasis and hairy leukoplakia as progression markers of HIV infection in Brazilian patients

Oral candidiasis (OC) and hairy leukoplakia (HL) are important markers of HIV (Human Imunodeficiency syndrome) infection progression for AIDS, mainly in locals where specific tests are inacessible. AIM: to intertwine OC and HL to CD4+ counting and to viral charge (VC) on HIV positive brazilian patients, confirming them as trustworthy clinical markers of the disease progression. STUDY DESIGN: Longitudinal cohort. MATERIAL AND METHOD: we have prospectively evaluated 124 HIV+ patients not in use of antiretroviral therapy. All of them have undertaken otorrhinolaringologic examination and CD4+ and VC counting, being divided in two groups: P and A, accordingly to presence or absence of OC and HL. After six months, patients belonging to the A group were re-divided on groups P6 (presence of lesions) and A6 (absence of lesions). Again, CD4+ and VC were counted. The results were statistically evaluated. RESULTS: on the P group, (43 patients, 28 OC, 15 HL) the CD4+ counting was smaller with greater viral charge when compared to A group (P<0.001). After 6 months, 15 of the 81 patients from the A group were excluded as they have initiated antiretroviral therapy. Eighteen patients (11 OC and 7 HL) were included on the P6 group. The others, who were free of lesions, were allocated on the A6 group. Again, CD4+ counting on the P6 group was smaller compared to the A6 group (P<0.001). The opposite occurred to the viral charge. DISCUSSION AND CONCLUSIONS: OC and HL indicate CD4+ counting below 300 cells/mm³ and increased VC, thus being trustable clinical markers of the disease progression.

HIV; AIDS; oral candidiasis; hairy leukoplakia

ABORL-CCF Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial Av. Indianápolis, 740, 04062-001 São Paulo SP - Brazil, Tel./Fax: (55 11) 5052-9515 - São Paulo - SP - Brazil
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