Document 0556
 DOCN  M9650556
 TI    The accurate diagnosis of oral lesions in human immunodeficiency virus
       infection. Impact on medical staging.
 DT    9605
 AU    Cruz GD; Lamster IB; Begg MD; Phelan JA; Gorman JM; el-Sadr W; New York
       City (NY) Department of Health, USA.
 SO    Arch Otolaryngol Head Neck Surg. 1996 Jan;122(1):68-73. Unique
       Identifier : AIDSLINE MED/96133394
 AB    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.
 DE    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 ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).