An Assessment of the Association Between Hard Tissue Lesions and Soft Tissue Lesions in Adult HIV+ Patients

1UIC College of Dentistry, Chicago, IL, 2Nova Southeastern University College of Dental Medicine, Fort Lauderdale, FL, USA

Objectives: HIV-positive dental patients are at high risk for oral hard (HTL) and soft tissue lesions (STL). Little has been published on connections between HTL and STL. The purpose of this study is to assess the association between HTL and STL in adult HIV-positive dental patients.

Methods: A retrospective chart audit of HTL was performed of patients of the former UIC College of Dentistry Ryan White Dental Clinic. STL data from a previous study were merged with the HTL data and the combined data set was analyzed using SPSS.

Results: The study population (n=71), with a mean age in years of 44.7(SD+8.8), was predominantly black (52.9%), homosexual (53.6%), male (80.3%), poor (annual income less than $5,000, 53.9%), limited in health insurance (none 43.9% and Medicaid 29.8%) and smoked (50.7%). Immune status measurements were taken an average 105(+67) months since seroconversion and demonstrated a mean CD4 count of 372(+196), and mean viral load of 14,695(+29,879). The mean HTL assessments were sound teeth (ST) =12.5(+7.9), DT=7.4(+5.3), FT=3.1(+3.5), MT=8.3(+6.1), DFT=10.5(+5.5), and DMFT=18.8(+7.7). The STL data showed 52.1% had an abnormal soft tissue exam: 36.6% had oral candidiasis, 9.9% had hairy leukoplakia, and 5.6% had oral warts. Important bivariate contrasts of HTL means included: abnormal or normal STL exam and DFT (9.3 and 11.8, p=.06); oral candidiasis or not and MT (10.2 and 7.2, p=.048); oral warts or not and FT (0.3 and 3.3, p=.09); and hairy leukoplakia or not and ST (20.4 vs. 11.6, p=.004), DT (3.9 vs. 7.8, p=.06), DFT (5.1 vs. 11.1, p=.006), and DMFT (10.4 vs. 19.8, p=.002).

Conclusion: The expected association of having STL and elevated measures of HTL did not occur except between oral candidiasis and missing teeth. Further analysis of these data and additional studies are necessary to verify the findings and explore the plausibility of oral lesions for immune surveillance of HIV+ individuals.