The effect of highly active antiretroviral therapy on the prevalence of oral manifestation in human immunodeficiency virus-infected patients in Karnataka, India

Abstract

Objectives:Acquired Immunodeficiency Syndrome (AIDS) is a highly lethal, progressively epidemic viral infection characterized by profound impairment of the immune system. Oral manifestations are common in Human Immunodeficiency Virus (HIV) infected AIDS patients, and are usually the first indicator of symptom and disease progression. The main objective of the current study was to compare the prevalence of oral manifestations in HIV patients on Highly Active Antiretroviral Therapy (HAART) with those, not on HAART therapies.Materials and Methods:A cross sectional study was conducted among 100 patients diagnosed as human immune virus sero-positive. These patients were divided equally into two groups (50 each); Group I patients on HAART and Group II patients who were not on HAART. Information regarding age, sex and cluster of differentiation 4 cell count was obtained from the medical records. Oral examination was done, and findings were recorded by using internationally accepted presumptive clinical criteria. Statistical analysis was performed using Chi-square statistical test.Results:The presence of oral manifestations was significantly decreased in subjects on HAART (32%) compared to those who are not on HAART (56%). The most common oral lesions detected in patients on HAART were increased oral hyper-pigmentation (14%), recurrent aphthous stomatitis (8%), non-specific ulcerations (4%), pseudo-membranous candidiasis (2%), periodontitis (2%) and xerostomia (2%), whereas in non HAART oral hyperpigmentation (10%), pseudo-membranous candidiasis (8%), angular cheilitis (4%), and erythematous candidiasis (4%) and Periodontitis (14%) were more prevalent.Conclusion:The number and severity of oral manifestation decreased, and even there was a change in the type of oral manifestations on HAART, which may be because of the improvement in immunity gained by the therapy.

Oral Manifestations in HIV-Positive Children: A Systematic Review

“…Moreover, some authors have argued that the weakening of the immune system by HIV would not be correlated to the onset of gingivitis, as it would only be correlated to the severity of the gingival lesions [32].…”

A relationship between CD4 count and oral manifestations of human immunodeficiency virus-infected patients on highly active antiretroviral therapy in urban population

“…The HIV attacks and disturbs the delicate balance of host's immune response, thereby rendering the host susceptible to a lot of life-threatening opportunistic infections, neurological disorders, unusual malignancies and oral lesions. [ 1 2 ] HIV infection is an extremely complex disease which affects numerous systems such as central nervous system, cardiovascular system and hematolymphoid organs. [ 11 ]…”

“…The patients who are on HAART will also show some common secondary manifestation like oral melanotic pigmentation, which is one of the physiologic manifestations. [ 2 10 ]…”

“…[ 1 ] India is the third largest country in the number of HIV-infected patients and according to the WHO, in 2012, an estimated 2.3 million individuals worldwide were newly infected with HIV. [ 2 ] It is a critical disorder of the immune system which severely damages the body's normal defense to infections, thereby making the host vulnerable to various infections and conditions including malignancies, which then become life-threatening. [ 1 ] With the advent of highly active antiretroviral therapy (HAART), people are living longer and are suffering fewer opportunistic infections.…”

“…For persons living with HIV disease who are not yet on therapy, the presence of certain oral manifestations may signal progression of HIV disease. [ 1 2 7 ]…”