Clinical evaluation of oral manifestations of HIV infection in relation to the CD4+ cell count and CD4+/CD8+ ratio.
Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. A10235)
Butt FM, Chindia ML, Vaghela VP University of Nairobi, Nairobi, Kenya
Background : The relationship between oral lesions arising from HIV infection and CD4+/CD8+ cell count is indeed a subject of particular interest to oral health care clinicians. The main objective of the study was to correlate the prevalence of oral manifestations arising from HIV infection and the levels of CD4+ cell count and the CD4+/CD8+ ratio. Methods : This was a prospective cross-sectional study involving hospitalized HIV infected patients at the Kenyatta National Hospital, Nairobi, Kenya. Patients recruited in the study were those aged 18 years and above, admitted due to ailments arising from HIV infection and never been on antiretroviral therapy. Duly signed consent was obtained after comprehensive counselling. Oral examination was then performed in both natural and artificial light with patients either lying supine in their beds or seated on a table chair in the medical wards. Any lesion detected and clinically characterized as a direct manifestation of HIV infection was then recorded in a special chart. 5 millilitres of venous blood was drawn for laboratory evaluation of CD4+/CD8+ cell count. Results : 207 patients were recruited in the study, 78(37.7%) were male and 129(62.3%) female, with an age range of 18-73 years (mean=34.8). The mean CD4+ cell count was 199 cells/mm3 and the mean CD4+/CD8+ ratio was 0.32 (95%CI 0.29-0.48). Oral manifestations encountered with highest prevalence in the oral cavity included: angular cheilitis 32.4%, hyperplastic candidosis (labial mucosa) 15%, erythematous candidosis(gingival) 5%, Kaposi's sarcoma (hard and soft palate) 2.9%, parotid enlargement 2%, herpes simplex (corner of the mouth) 0.5% and persistent oral ulceration (labial mucosa)0.5%. Conclusion : The prevalence of oral manifestations in HIV was higher with low CD4+ cell count<200cell/mm3 and low CD4/CD8 ratio<0.30.
Keywords: AEGIS, CD4 Lymphocyte Count, Antigens, CD8, Antigens, CD4, HIV Infections, Prevalence, Acquired Immunodeficiency Syndrome, Mouth Diseases, Candidiasis, Oral, HIV Seropositivity, CD8-Positive T-Lymphocytes, Cross-Sectional Studies, Parotid Diseases, Kenya, Humans, Female, Male, immunology, methods
