Oral manifestations of HIV infection and their correlation with CD4 count

Abstract

Human Immunodeficiency Virus (HIV)-related oral lesions can be used as markers of the immune status. The present cross-sectional study was conducted to identify the oral manifestations in HIV-infected individuals and their association with reduced Cluster of Differentiation 4 (CD4) count. The study population included known HIV-positive patients. A detailed case history of 399 HIV-positive patients was obtained and general examination was carried out. Diagnosis of oral lesions was done based on presumptive criteria of EEC Clearinghouse, 1993. The CD4 count was determined in 369 patients and correlated with oral manifestations. The prevalence of oral lesions was found to be 76.70% (n = 306). Oral candidiasis (157 (39.3%)) was the most common oral lesion associated with HIV infection. Amongst various forms of oral candidiasis, erythematous candidiasis (122 (39.3%)) outnumbered the other forms. The mean CD4 count of patients with oral lesions (207 cells/mm(3)) was less than in patients without oral lesions (291 cells/mm(3)) (P = 0.002). Oral candidiasis was found to be significantly correlated to a reduced CD4 cell count below 200 cells/mm(3) (P = 0.000; Odds ratio = 3.1; 95% Confidence interval 1.9-4.9) with good sensitivity, best specificity and positive predictive value. Oral manifestations may be used as an alternative to CD4 count at field-based settings to diagnose the immune compromised status of HIV-infected individuals.

A Study on clinical patterns of mucocutaneous candidiasis in immunosuppressed patients

“…All three HIV patients with oral candidiasis had their CD4 counts were between 374-400 cells /mm3. Bodhade et al and Campo et al proposed that oral manifestations were common in HIV patients with CD4 counts less than 200 cells /mm 3 [17][18][19]. The presence of oral candidiasis in HIV patients in this study could be due to other contributing factors like poor oral hygiene and the prolonged use of antibiotics for prevention of opportunistic infection [20,21].…”

Correlation between oral lesions and opportunistic infections among human immunodeficiency virus — infected individuals in Indian population

“…This difference can be due to differences in the prescribed medications, the stages of the disease or the way of transmission of the infection. Also pseudomembranous and erythematous candidiasis are supposed to be better markers of immune suppression than any other oral lesions as indicated by Bodhade et al [25].…”

EBV-positive mucocutaneous ulcer of the oral cavity associated with HIV/AIDS

“…14 The diverse origin of ulcers in these patients is diagnostically challenging and may result in delayed therapeutic management. 1 The ability to distinguish between the varied etiologies both clinically and histopathologically is thus essential.…”