Oral manifestations of human immunodeficiency virus/acquired immunodeficiency syndrome and their correlation to cluster of differentiation lymphocyte count in population of North-East India in highly active antiretroviral therapy era

Abstract

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/mm3. 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.

Determinants of periodontitis according to the immunological and virological profiles of HIV-infected patients in Yaoundé, Cameroon

“…To reduce the risk of opportunistic infections, including oral manifestations, international medical associations developed guidelines for starting antiretroviral treatment despite the CD4 cell counts in these patients known as the test and treat approach implemented in Cameroon since 2016 [ 7 ]. Importantly, patients with HIV may present distinct immunological/virological profiles and different oral manifestations [ 8 ]. The immunological parameter usually used for this evaluation is the CD4/CD8 T-lymphocyte counts in peripheral blood and plasma viral load, which appear to play an important role in the progression of periodontal disease and the course of HIV-infection [ 9 ].…”

<p>Assessing the levels of HIV-related knowledge and attitudes toward HIV-infected patients among undergraduate dental students: a cross-sectional study</p>

“…It is well known that HIV infection negatively affects oral health wherein 40%–70% of HIV-positive individuals develop oral complications such as Kaposi sarcoma, oral candidiasis, and leukoplakia during disease progression 3,4. Due to dry mouth symptoms and lack of cleansing action of saliva, these patients also suffer from multiple carious lesions and periodontal problems 5,6.…”

CD4 cells count as a prognostic marker in HIV patients with comparative analysis of various studies in Asia Pacific region

“…These results are consistent with findings of other investigators who examined oral lesions and conditions associated with HIV positive patients. [ 8 14 18 19 20 21 22 23 24 25 26 ]…”