Epidemiology of HIV-related oral manifestations in women: a review.

OBJECTIVE: (1) To assess the extent of knowledge acquired since 1981 on the epidemiology of HIV-related oral manifestations in women; (2) to determine if these findings differ by gender; and (3) to assess the needs and direction for future epidemiologic research on oral disease and HIV infection in women in relation to men. DATA IDENTIFICATION: A computer-assisted search was conducted to identify epidemiologic studies reporting the frequency of various oral conditions in HIV-infected women. Studies on periodontal disease as manifestation of HIV infection were not included. DATA EXTRACTION: Methods used in the retrieved articles were reviewed with respect to target population, study design, sampling scheme, outcomes, measurements and statistical issues. Results were summarized in relation to oral findings in HIV-infected men. RESULTS OF DATA SYNTHESIS: Most studies were prospective, and sample selection was non-random. Studies differed with respect to geographic location, risk category for HIV transmission, and stage of HIV disease. Despite these differences, oral lesions were found in at least 15% of HIV-infected women, and the most common oral lesion in all studies was candidiasis. Women differed from men with respect to the prevalence of hairy leukoplakia and Kaposi's sarcoma (KS) both of which were significantly less common in women.
CONCLUSION: Future epidemiologic studies should be directed at identifying cofactors involved in addition to Epstein-Barr virus (EBV) in the development of hairy leukoplakia, and in addition to KS herpes virus (KSHV) in the occurrence of KS.