This application proposes a study of the epidemiology of oral lesions among heterosexual women and men in Senegal, West Africa, who may be infected with either HIV-1, HIV-2, both HIV-1 and HIV-2, or who are HIV seronegative. Oral lesions are reported to develop among a substantial number of HIV infected individuals, and because incidence of HIV infection is greater in developing countries, a large percentage of those patients with HIV associated oral lesions will come from these settings. However, few systematic studies of the epidemiology of HIV associated oral disease in these populations have been undertaken. Many have reported on oral lesions among HIV-1 infected men, but many fewer data are available from women. Although AIDS is associated with HIV-2, as well as with HIV-1, in many West African countries, no published data is available concerning the risk of oral pathology associated with HIV-2. Comparative studies of oral lesions among those with HIV-1, HIV-2, or both HIV types, taking into account other potential risk factors for these lesions, are of particular interest because of the slower rate of immune function decline seen with HIV-2 as compared with HIV-1. Little is known about the frequency with which HIV-1 or HIV-2 can be detected within the oral cavity. Defining risk and predictors of oral HIV-1 and HIV-2 DNA/RNA may be important with respect to implications for our increased understanding of the natural history of HIV infection and potentially of HIV transmission. Correlation of the presence and quantity of oral HIV with HIV in the peripheral blood, CD4 count, and demographic characteristics, may provide insights into potential observed differences. This application proposes to address these issues using the infrastructure which has been developed in Senegal conducting cross-sectional (R01CA50856) and now cohort (R01CA46823) studies of HIV and neoplasia. The investigators plan to recruit women enrolling in that study, as well as to recruit men presenting to the same study clinic. The extensive data already being collected from the women participating in this other cohort study will be available to the proposed study. Specifically among cohorts of women and men with HIV-1, HIV-2, or both HIV-1 and HIV-2, and among HIV seronegative subjects, the investigators propose to: (1) describe the prevalence and nature of oral lesions associated with each HIV type; and (2) compare the quantity of detectable HIV DNA/RNA in the oral cavity with respect to the infecting HIV type and risk factors for its detection.
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