This Article  • References  • Full text PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Impact on Medical Staging

Gustavo D. Cruz, DMD, MPH; Ira B. Lamster, DDS, MMSc; Melissa D. Begg, ScD; Joan A. Phelan, DDS; Jack M. Gorman, MD; Wafaa El-Sadr, MD, MPH

Arch Otolaryngol Head Neck Surg. 1996;122(1):68-73.

Abstract
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.

(Arch Otolaryngol Head Neck Surg. 1996;122:68-73)

Author Affiliations
From the New York City (NY) Department of Health (Dr Cruz); School of Dental and Oral Surgery (Drs Cruz and Lamster), Division of Biostatistics, School of Public Health (Dr Begg), and Department of Psychiatry, College of Physicians and Surgeons (Dr Gorman), Columbia University, New York; Dental Service, Veterans Affairs Medical Center, Northport, NY (Dr Phelan); and Division of Infectious Diseases, Harlem (NY) Hospital Center (Dr El-Sadr).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Oral Lesions of HIV Disease and HAART in Industrialized Countries
Hodgson et al.
ADR 2006;19:57-62.
ABSTRACT | FULL TEXT  

The significance of oral health in HIV disease
Chapple and Hamburger
Sex. Transm. Infect. 2000;76:236-243.
FULL TEXT