Yatish Kumar Sanadhya1, Sudhanshu Sanadhya2, Ramesh Nagarajappa3

International Maritime Health, 2014

Background: Human immunodeficiency virus (HIV) infection is a major global health problem. Tuberculosis and cryptococcal meningitis are the leading cause of death among people living with HIV. Aim: The purpose of this study was to determine whether any relationship exists between the occurrence of oral lesions and opportunistic infections among HIV-infected patients in Indian population. Materials and methods: A cross-sectional analytical study was performed in 232 HIV-infected persons (148 males and 84 females, aged 20-60 years, mean 33.6 ± 2.3 years). c 2 test and logistic regression were used for statistical analysis. Results: Oral candidiasis was the most common oral lesion seen in 28.4% males and 22.6% females of HIV-infected persons, followed by hairy leukoplakia in 27% males and 20.2% females which was statistically significant. Tuberculosis (21.6%) followed by cryptococcosis (9.9%) and pneumocystis carinii pneumonia (4.7%) were the most commonly found opportunistic infections. Logistic regression analysis revealed a significant association, between the occurrence of tuberculosis and candidiasis (OR 2.3; cryptococcosis and candidiasis (OR 1.4;, and pneumocystis carinii pneumonia with hairy leukoplakia (OR 1.6; 95% CI 1.0-2.9). Mean CD4 count was also less. Conclusions: The results suggest a definite relationship in occurrence of oral lesions and opportunistic infections among HIV-infected patients.

Bulletin of the World Health Organization, 2005

This paper discusses the importance of oral lesions as indicators of infection with human immunodeficiency virus (HIV) and as predictors of progression of HIV disease to acquired immunodeficiency syndrome (AIDS). Oral manifestations are among the earliest and most important indicators of infection with HIV. Seven cardinal lesions, oral candidiasis, hairy leukoplakia, Kaposi sarcoma, linear gingival erythema, necrotizing ulcerative gingivitis, necrotizing ulcerative periodontitis and non-Hodgkin lymphoma, which are strongly associated with HIV infection, have been identified and internationally calibrated, and are seen in both developed and developing countries. They may provide a strong indication of HIV infection and be present in the majority of HIV-infected people. Antiretroviral therapy may affect the prevalence of HIV-related lesions. The presence of oral lesions can have a significant impact on health-related quality of life. Oral health is strongly associated with physical an...

BioDiscovery, 2012

The aim of this study was to find the prevalence of oral lesions in human immunodeficiency virus (HIV) positive patients and investigate if there was a relationship between oral manifestations and the level of immunosuppression. 125 patients infected with HIV in the age group of 20-40 years were examined for the presence of different oral lesions according to the EEC criterion. The CD4 count, as well as any therapy being instituted was recorded and correlated with the oral manifestations seen. Comparison of common oral lesions present to absent was done by chi square test using linear by linear association. The prevalence of oral lesions among the investigated HIV patients was found to be 71%, with periodontitis-52% and erythematous candidiasis-48% being the most prevalent oral lesions; as well, periodontitis and oral hairy leukoplakia were found to be significantly associated with the immunosuppression in the disease. Thus, oral lesions have been found to be associated with the early manifestation of HIV and a measure of disease severity.

Journal of International Oral Health : JIOH, 2015

Background: The aim of this study was to evaluate the clinical lesions of human immunodeficiency virus (HIV)/acquired immune deficiency syndrome patients in the oral cavity, head and neck region and to determine their associations with level of immune suppression as measured by the CD4+ count. Materials and Methods: In a descriptive cross-sectional study, 50 patients with a proven HIV infection were evaluated. Based on the clinical findings and CD4+ counts, the relationships between oral lesions and CD4+ cell count were investigated. Results: The CD4+ count (cells/mm3) was <200, 200-500, and >500 in 32 cases (64%), 16 cases (32%) and 2 cases (4%) respectively, and the mean CD4+ count was 169.82 cells/mm3 in males and 142.8 cells/mm3 in females. All patients showed at least one oral manifestation. The most common oral lesion identified was pseudomembranous candidiasis accounting for 76% (38/50) followed by periodontal disease 34% (17/50), herpetic lesions and hairy leukoplakia ...

Journal of the Korean Association of Oral and Maxillofacial Surgeons, 2017

Objectives: The objective of this study was to investigate the presence of oral lesions in human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients in a descriptive cross-sectional study, and to establish their presence according to levels of CD4+ cells (including the CD4+/CD8+ cell ratio). Materials and Methods: A total of 75 patients infected with HIV were included. Oral lesions were observed and classified using World Health Organization classification guidelines. Potential correlations between the presence and severity of oral lesions and CD4+ cells, including the CD4+/CD8+ cell ratio, were studied. Results: The most frequent oral lesion detected was oral pseudomembranous candidiasis (80.0%), followed by periodontal disease (40.0%), herpetic lesions (16.0%), hairy leukoplakia (16.0%), gingivitis (20.0%), oral ulceration (12.0%), Kaposi’s sarcoma (8.0%), and non-Hodgkin’s lymphoma (4.0%). The CD4+ count was <200 cells/mm3 in 45 cases (60.0%), between 200-500 cells/mm3 in 18 cases (24.0%), and >500 cells/mm3 in 12 cases (16.0%). The mean CD4+ count was 182.18 cells/mm3 . The mean ratio of CD4+/CD8+ cells was 0.26. All patients showed at least one oral manifestation. Conclusion: There was no correlation between the CD4+/CD8+ cell ratio and the presence of oral lesions. The severity of the lesions was more pronounced when the CD4+ cell count was less than 200 cells/mm3 .

Medicine, 2003

In developing countries, the variations in the clinical spectrum of human immunodeficiency virus (HIV)-related oral lesions over time, and the possible effects of antiretroviral therapy, have not been described. In this study we evaluate the clinical spectrum of oral lesions in a series of HIV-infected patients when first examined at the acquired immunodeficiency syndrome (AIDS) clinic of a tertiary care institution in Mexico City, Mexico, and the changes observed over 12 years.

2011

The aim of this study was to determine the prevalence of oral lesions and systemic diseases in HIV- infected subjects and to assess possible relationship between them. This was a cross-sectional analytical study. Oral examination was performed in HIV-infected adult individuals. CD4+ count and viral load were recorded and systemic diseases classified. The most common oral lesions were oral candidiasis (26.8%), oral hairy leukoplakia (7.3%) and salivary gland enlargement (6.1%), and systemic diseases were diarrhea (36.6%), HPV infection (24.4%), genital herpes (18.3%), gonorrhea (14.6%), herpes zoster virus infection (13.4%), toxoplasmosis (13.4%) and syphilis (12.2%). A significant association was found between oral lesions and systemic diseases (p = 0.005) and particularly with diarrhea (p = 0.010). There was a significant association between oral candidiasis and systemic diseases (p = 0.030), STDs (p = 0.039), diarrhea (p = 0.023), Pneumocytis jiroveci pneumonia (p=0.014) and furun...

Contemporary Clinical Dentistry, 2016

Background: The human immunodeficiency virus (HIV) infection which manifests as acquired immunodeficiency syndrome (AIDS) is a disease involving the defects of the T-lymphocyte arm of the immune system. Certain laboratory parameters such as the cluster of differentiation (CD4) count and clinical parameters have long been used as markers of disease progression. In industrialized countries, many studies show a highly correlation between the incidence of oral lesions and immunosuppression and hence, can be used as a marker of immunosuppression. This might not be applicable to a developing country like India. In this study, efforts have been made to supplement the present knowledge on various aspects of oral manifestations in HIV patients in the Indian subcontinent. Aims: To correlate the oral manifestations in HIV/AIDS patients to the level of circulating CD4+ T-lymphocyte count and their effect in anti-retroviral therapy (ART). Subjects and Methods: A total of 104 HIV positive patients were examined for oral lesions. The CD4 count estimated on the same day by fluorescent activated cell sort count machine was then correlated with various oral lesions. Results: Oral manifestations appeared when CD4 count decreased below 500 cells/mm 3. Moreover, oral lesions found at different stages showed very strong correlation to their respective CD4 count. Furthermore, there was considerable decline in the incidence of oral manifestations in patients undergoing highly active ART. Conclusions: Oral manifestations are highly predictive markers of severe immune deterioration and disease progression in HIV patients.

JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH

Introduction: The Oral Manifestations (OM) of Human Immunodeficiency Virus (HIV) is indication of compromised immune status and disease progression. These Oral Lesions (OL) cause morbidity and affect quality of life of the patients. Aim: To evaluate the association between OM in patients with HIV infection and their level of cluster of differentiation 4 (CD4) count. Materials and Methods: The study was designed as a descriptive, cross-sectional study for a duration of two years which included a total of 565 known HIV-positive individuals visiting the regional Antiretroviral Therapy (ART) center for counseling and/or on Highly Active Antiretroviral Therapy (HAART) were selected irrespective of age and sex. The oral lesions were diagnosed using the presumptive criteria given by by the European Committee (EC) Clearinghouse, 1993. Oral and systemic manifestations were recorded and associated with CD4 counts. The data collected was subjected to statistical analysis using Statistical Pack...

Journal of Oral Pathology & Medicine, 2007

BACKGROUND: The advent of highly active antiretroviral therapy (HAART) has changed the scenario of human immunodeficiency virus (HIV) infection. HIV patients in India have now access to generic HAART and this is the first report describing oral lesions in patients on HAART from our country. METHODS: Oral lesions were studied in HIV seropositive patients (n ¼ 50 on HAART and n ¼ 50 not on HAART) attending a tertiary HIV referral care centre in India and patients on HAART were followed up. RESULTS: There was a difference in the occurrence of oral candidiasis (OC) between HAART and non-HAART participants (8%, 24%; P < 0.05). Pseudomembranous candidiasis was 4% and 18% in HAART and non-HAART groups respectively (P < 0.05). In patients with CD4 count £200, OC was 5.6% in the HAART group and 39.1% in the non-HAART group (P < 0.05). Among patients with CD4 count >200, pigmentation was 43.8% in the HAART group and 14.8% in the non-HAART group (P < 0.05). CONCLUSION: The prevalence of OC in patients who had access to HAART was less when compared with those who did not have access to HAART. J Oral Pathol Med (2007) 36: 136-41