Hiv-related oral manifestations in two cohorts of women in San Francisco

Caroline H. Shiboski, Joan F. Hilton, Deborah Greenspan, Janice L. Westenhouse, Pamela Derish, Karen Vranizan, Alan R. Lifson, Alison Canchola, Mitchell H. Katz, Judith B. Cohen, Andrew R. Moss, John S. Greenspa

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62 Scopus citations


The goals of this study were to compare the prevalence of oral lesions in women infected with human immunodeficiency virus (HIV) and HIV-negative women, and to determine the association of oral lesions with route of HIV transmission and with level of immunosuppression in infected women. As part of a prospective 4-year study, oral examinations and blood tests were performed, at 6-month intervals, on 176 HIV-infected women and on 117 HIV-negative women at risk for HIV infection. We evaluated participants for the following oral conditions: hairy leukoplakia, candidiasis, ulcers, warts, non-Hodgkin’s lymphoma, Kaposi’s sarcoma, and parotid enlargement. As previously reported in men, the prevalence of oral lesions was significantly higher among HIV-infected (22%) than HIV-negative women (3%) [odds ratio (OR) = 8.2; 95% confidence interval (CI) 2.8, 23.5], particularly candidiasis (14%) and hairy leukoplakia (10%). Among HIV-infected women with CD4 cell count nadir ≥200 cells/μl, the prevalence of hairy leukoplakia was higher among those infected heterosexually than among injection drug users (OR = 5.5; 95% CI: 1.5; 19). The OR for the association between oral lesions and CD4 cell count nadir (<200 vs. >500 cells/μl) was 8.9 (95% CI: 2.6, 30), indicating a strong positive association with level of immunosuppression.

Original languageEnglish (US)
Pages (from-to)964-971
Number of pages8
JournalJournal of Acquired Immune Deficiency Syndromes
Issue number9
StatePublished - Sep 1994


  • HIV infection
  • Heterosexual transmission
  • Injection drug use
  • Oral lesion
  • Prospective studies
  • Women


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