Accuracy of diagnoses of HIV-related oral lesions by medical clinicians, Findings from the Women's Interagency HIV Study

Joan F. Hilton, Mario Alves, Kathy Anastos, Alison J. Canchola, Mardge Cohen, Robert Delapenha, Deborah Greenspan, Alexandra Levine, Laurie A. MacPhail, Sandra J. Micci, Roseann Mulligan, Mahvesh Navazesh, Joan Phelan, Peter Tsaknis

Research output: Contribution to journalArticlepeer-review


Objective: To determine if medical clinicians are as accurate as dental clinicians in recognizing diagnostic characteristics of HIV-related oral lesions. Methods: In 355 HIV-infected participants at five Women's Interagency HIV Study sites, we paired oral examinations conducted within 7 days of each other by dental and medical clinicians. We used the former as a gold standard against which to evaluate the accuracy of the latter. We assessed the accuracy of the medical clinicians' findings based both on their observations of abnormalities and on their descriptions of these abnormalities. Results: Dental clinicians diagnosed some oral abnormality in 38% of participants. When "abnormality" was used as the medical clinicians' outcome, sensitivities were 75% for pseudomembranous candidiasis and 58% for erythematous candidiasis, but only 40% for hairy leukoplakia. When a precise description of the abnormality was used as their outcome, sensitivities were 19%, 12% and 20%, respectively. Conclusions: Medical clinicians recognize that HIV-related oral abnormalities are present in 40-75% of cases, but less often describe them accurately. Low sensitivity implies that the true associations of specific oral lesions with other HIV phenomena, such as time until AIDS, must be stronger than the literature suggests.

Original languageEnglish (US)
Pages (from-to)362-372
Number of pages11
JournalCommunity Dentistry and Oral Epidemiology
Issue number5
StatePublished - 2001


  • Aids-related opportunistic infections, epidemiology
  • Mouth diseases
  • Primary health care, statistics & numerical data
  • Women's health

ASJC Scopus subject areas

  • General Dentistry
  • Public Health, Environmental and Occupational Health


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