Aetiological factors for oral manifestations of HIV.

Objectives: Describe the oral diseases in HIV-infected individuals in London, UK and identify social and medical factors related to the presence of specific oral diseases.

Design: Dental clinics.

Subjects: Consecutive sample of 456 patients with HIV infection.

Methods: Social and medical history and clinical examinations. Univariate and logistic regression analysis.

Outcomes: Presence of HIV-associated oral disease.

Results: 80% of patients with AIDS and 50% of patients with HIV had a specific oral disease. The most common diseases were hairy leukoplakia (30%), erythematous candidiasis (24%), pseudomembranous candidiasis (14%), angular chielitis (6%), necrotising periodontal disease (8%) and non-recurrent ulceration (6%).

Conclusions: The presence of erythematous candidiasis was not related to advanced HIV disease. Pseudo-membranous candidiasis, hairy leukoplakia and mucosal ulceration were significantly associated with advanced HIV disease. Smoking was also identified as a strong aetiological factor in oral diseases. Longitudinal studies are required to further explore the prognostic significance of oral diseases in HIV infection.