Oral lesions associated with HIV infection, as classified by the EC-Clearinghouse on Oral Problems related to HIV infection and the WHO Collaborating Centre on Oral manifestations of the immunodeficiency virus, were studied in 600 consecutive HIV-infected patients in Cape Town, South Africa. One or more lesions were seen in 60.4% of cases. Combined candidal lesions were evident in 37.8%, hairy leukoplakia in 19.7% and combined gingival/periodontal lesions in 8.5% of patients seen. Lesions less commonly recorded include oral ulceration (2.9%) and Kaposi's sarcoma (1.5%). The clinical range of lesions seen is similar to those reported elsewhere, but socio-cultural differences allowed no reliable comparison. More than a quarter of our patients had oral soft tissue discomfort necessitating treatment; in 3.3% these were the presenting symptom. This indicates a potential major public health concern requiring education in recognition and appropriate referral and management.
PIP: The prevalence and clinical appearance of oral manifestations of HIV were investigated in 600 consecutive HIV patients examined at health care facilities in Cape Town, South Africa, in 1993-96. At least 1 oral lesion was present in 362 patients (60.4%). 160 oral manifestations (26.7%) were symptomatic and required treatment. The majority of lesions (37.8%) were candidosis, primarily pseudomembranous and erythematous types. Oral hairy leukoplakia was present in 19.7% of patients, while HIV-related peridontal disease was noted in 8.5%. 20 HIV-positive patients (3.3%) presented with an oral manifestation of HIV infection before HIV was diagnosed. Classifications were based on guidelines developed by the EC-Clearinghouse on Oral Problems Related to HIV Infection and the World Health Organization Collaborating Center on Oral Manifestations of the Immunodeficiency Virus. These findings, which are similar to those reported in other developed and developing countries, indicate a need for education on the recognition and appropriate management and referral of oral manifestations of HIV infection.