Oral lesions as predictors of highly active antiretroviral therapy failure in Brazilian HIV-infected children

• Published in: Journal of oral pathology & medicine 2008-02, Vol.37 (2), p.99-106
• Main Authors: Miziara, Ivan Dieb, Weber, Raimar
• Format: Article
• Language: English
• Subjects: AIDS; antiretroviral therapy; Antiretroviral Therapy, Highly Active - statistics & numerical data; Biological and medical sciences; Brazil; CD4 Lymphocyte Count; Child; Child, Preschool; Cross-Sectional Studies; Dentistry; Female; HIV Infections - complications; HIV Infections - drug therapy; human immunodeficiency virus; Human viral diseases; Humans; Immunodeficiencies; Immunodeficiencies. Immunoglobulinopathies; Immunopathology; Infant; Infectious diseases; Longitudinal Studies; Male; Medical sciences; Mouth Diseases - complications; oral candidosis; Otorhinolaryngology. Stomatology; Prognosis; Protease Inhibitors - therapeutic use; Risk Factors; Sensitivity and Specificity; Statistics, Nonparametric; Treatment Failure; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Viral Load
• ISSN: 0904-2512; 1600-0714
• DOI: 10.1111/j.1600-0714.2007.00598.x

Objectives:  Evaluate the accuracy of HIV‐related oral lesions to predict immune and virologic failure on HIV‐infected children in use of highly active antiretroviral therapy (HAART). Study design:  Data for this cross‐sectional analysis come from a longitudinal study being conducted through the HIV‐AIDS Outpatient Unit, ENT Division, Hospital das Clinicas, Sao Paulo University Medical School. The study began in January 1990 and is still ongoing. The cut‐off point for analyses purposes was December 2004. Subjects were 471 HIV‐infected consecutive children attending the outpatient unit during this period, who enrolled regardless of medical or immunological status. The children have undertaken oral cavity examination, serum CD4+ T‐lymphocyte count, and, 271 of them, viral load measurement. Sensitivity, specificity, positive predictive value, negative predictive value and relative risk were calculated. Results:  Oral lesions had moderate sensitivity, high specificity and positive predictive value to predict immune failure. It had low sensitivity and positive predictive value, and high specificity to predict virologic failure. Discussion and conclusions:  Oral manifestations of HIV can be important markers for immune suppression and for virologic failure, in Brazilian children undergoing HAART.