Table of Contents
ISRN Infectious Diseases
Volume 2013 (2013), Article ID 269728, 7 pages
http://dx.doi.org/10.5402/2013/269728
Research Article

Oral Lesions: Poor Markers of Virologic Failure in HIV-Infected Patients on Antiretroviral Therapy

1Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35294, USA
2Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, 1155 Pressler St., Unit 1330, CPB3.3202, Houston, TX 77030-4009, USA
3Department of Infectious Diseases, School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA
4Vanderbilt Institute for Global Health, Vanderbilt University, Nashville, TN 37203, USA
5Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35294, USA
6Department of Predoctoral General Dentistry, School of Dentistry, University of Alabama at Birmingham, Birmingham, AL 35294, USA
7Sparkman Center for Global Health, University of Alabama at Birmingham, Birmingham, AL 35294, USA

Received 18 September 2012; Accepted 14 October 2012

Academic Editors: G. A. Funk and G. Simo

Copyright © 2013 Irene Tami-Maury et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The objective of this study was to assess the use of HIV-oral lesions (OLs) as markers of virologic failure (VF) in response to antiretroviral therapy (ART). Concurrent virologic status was compared between 744 individuals with and without OL ( ). Time to VF between OL groups was compared (Kaplan-Meier), and baseline factors associated with VF were determined (Cox Hazard models). Sensitivity, specificity, positive predictive value, and negative predictive value were also computed. At baseline and 12 months, individuals with OL were more likely to have viral load copies/ml compared to patients without OL ( ). Time to VF between patients with baseline OL (mean: 17 months, 95% CI 16–18) and patients without baseline OL (mean: 19 months, 95% CI: 18–20) was statistically different. Patients who were African-American (HR 1.356; 95% CI: 1.045–0.759), ART-experienced (HR 2.298; 95% CI: 1.743–3.030), had mental disorders (HR 1.410; 95% CI: 1.078–1.843), and had high baseline viral load (HR 2.82; 95% CI: 1.661–3.137), were more likely to have VF after the first six months of ART. OL had a moderate positive predictive value for concurrent VF at 6 months (45.5%) and 18 months (33.3%), but a strong positive predictive value at 12 months (80.0%) and 24 months (100.0%). Findings of this study suggest that OLs could be poor predictors of VF in HIV-infected patients on ART therapy.