Oral candidiasis in HIV infection: Predictive value and comparison of findings in injecting drug users and homosexual men

The objectives of this study were to compare the relationship of oral candidiasis to HIV status, cohort and CD4+ lymphocyte values in injecting drug users and homosexual men and to examine its impact on prognosis. An oral examination was added to an ongoing longitudinal study of HIV infection. Data obtained at 6-month intervals included smoking, illicit drug use, medication use, symptoms and medical diagnoses, physical examination findings and laboratory data. In this study HIV+ subjects were much more likely to present with oral candidiasis than were HIV-subjects (OR=6.3, P<0.01). Injecting drug users, regardless of serostatus, were more likely than homosexual men to present with oral candidiasis (OR =3.0, P=0.001). In both cohorts oral candidiasis was associated with low CD4+ lymphocyte counts and percentages, and Kaplan-Meier survival estimates showed that subjects with oral candidiasis had a poorer prognosis than those without candidiasis, even after controlling for CD4+ lymphocyte count.