Oral manifestations of AIDS in a heterosexual population in a Zaire hospital

Abstract

Oral lesions associated with HIV infection as classified by the WHO Collaborative Centre for Oral manifestation of HIV were studied in 83 heterosexual AIDS patients in Kinshasa, Zaire. One or more lesions were fungal (94%), bacterial (33%) and viral (23%). Neoplasm was found in 12% of cases while lesions of unknown etiology in 14%. As location of those lesions, the palate, lips, tongue and the buccal mucosae mostly predominate as sites. The findings from this study were clinically similar to those reported in AIDS in other areas.

PIP: From January 1988-September 1989, dental practitioners performed a comprehensive oral examination on 83 HIV positive patients at the Department of Infectious Diseases, University Clinic of Internal Medicine in Kinshasa, Zaire for a study on prevalence and clinical aspects of oral lesions associated with HIV infection. Women comprised 55.5% of these AIDS patients. They all had oral lesions: 94% fungal, 33% bacterial, 23% viral, 14% unknown origin, and 12% neoplasms. The majority of these oral lesions developed in 31-40 year olds. Further, the 21-30 year olds were more likely to have bacterial infections, especially aggressive periodontitis. Fungal infections occurred most often on the lips, palate, and tongue, while viral infections occurred mainly on the tongue. Kaposi's sarcoma only afflicted the palate. Pseudomembranous candidiasis was the leading fungal infection (32% of all oral lesions) then atrophic (22.8%) and hyperplastic (6%) types. 17% and 16% of all lesions included these bacterial infections: aggressive periodontitis and necrotizing gingivitis respectively. the leading viral infection was hairy leukoplakia (14%) followed by leukoplakia (8%), and herpetic stomatitis (4%). The unknown lesions included ulcers (12%) and a swollen salivary gland )2%). 12% of the examined AIDS patients, mostly 31-50 year olds, had oral Kaposi's sarcoma. They also had it on other parts of the body. Since HIV prevalence in Zaire ranges between 3-8%, all dentists should be cognizant of oral manifestations of HIV which may indeed be the 1st clinical indications of HIV. They should refer any patients with such lesions to a health facility with AIDS specialists for diagnosis and care.