The Impact of Oral Examination on the Centers for Disease Control Classification of Subjects With Human Immunodeficiency Virus Infection

Abstract

Seventy patients infected with human immunodeficiency virus (HIV) have been included in this study to evaluate the impact of oral examination on the Centers for Disease Control (CDC), Atlanta, Ga, classification of HIV disease. Based on clinical data prior to oral examination, 22 patients were classified in the CDC group 2, 11 in CDC group 3, and 37 in CDC group 4. Twelve patients (55%) initially classified as CDC 2, and 4 patients (36%) initially classified as CDC 3 had to be reallocated to CDC group 4 due to the presence of oral candidiasis, hairy leukoplakia, or oral Kaposi's sarcoma. We conclude that oral examination has a large impact on the CDC classification of HIV-infected subjects. Since this classification system is used to select asymptomatic HIV-infected subjects (CDC groups 2 and 3) for clinical trials receiving antiretroviral therapy in early HIV disease, it is suggested that accurate oral examination is mandatory before inclusion of patients in such studies.