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. 2016 Sep-Dec;20(3):419-426.
doi: 10.4103/0973-029X.190934.

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

Gadavalli Vera Venkata Satyakiran  1 , Radhika Manoj Bavle  1 , Glory Alexander  2 , Saritha Rao  3 , Reshma Venugopal  1 , Sreelatha S Hosthor  1
Affiliations

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

Gadavalli Vera Venkata Satyakiran et al. J Oral Maxillofac Pathol. 2016 Sep-Dec.

Abstract

Introduction: Human immunodeficiency virus (HIV) infection gradually destroys the body's immune system, which makes it harder for the body to fight infections. HIV infection causes a quantitative and qualitative depletion of CD4 lymphocyte count, which increases the risk of opportunistic infections. Thus, CD4 count is one of the key factors in determining both the urgency of highly active antiretroviral therapy (HAART) initiation and the need of prophylaxis for opportunistic infections.

Aim: This study aims to evaluate the prevalence and variations in the oral manifestations of HIV/acquired immune deficiency syndrome patients on HAART therapy in urban population and their association with CD4 count.

Materials and methods: A study was conducted by screening eighty patients who were HIV positive in an urban location. Both adult and pediatric patients were screened for oral manifestations and simultaneously CD4 count was also evaluated. Patients with HIV infection for variable time period who are under HAART were considered.

Statistical analysis: Measures of central tendency were used to analyse the data.

Results: HIV infection destroys the immune system of an individual, making the patient susceptible to various infections and malignancies. With the advent of antiretroviral therapy, the scenario has changed drastically. We have observed that patients with CD4 counts between 164 and 1286 show relatively few oral manifestations. Long-term HAART therapy causes pigmentation, xerostomia and angular cheilitis but is taken up quite well by the patients.

Conclusion: In this study, eighty patients with HAART from urban population showed very minimal oral findings because of good accessibility for treatment and awareness about HIV infections. The patients who were on long-standing HAART treatment also showed minimal oral manifestation such as pigmentation and xerostomia. Hence, we conclude that recognition, significance and treatment of these lesions in patients with HIV infection do not require elaborate setup and can be treated with basic primary health care.

Keywords: Antiretroviral therapy; CD4 lymphocytes; human immunodeficiency virus; oral manifestations of AIDS; pigmentation; xerostomia.

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Figures

Figure 1
Figure 1
Clinical photograph revealing oral melanin pigmentation in adults patients. (a) Buccal mucosa. (b) Tongue
Figure 2
Figure 2
Clinical photograph revealing gingivitis in adult patients. (a) Upper free and attached gingiva. (b) Lower free gingiva
Figure 3
Figure 3
Clinical photograph revealing oral melanin pigmentation in pediatric patients. (a) Attached gingiva. (b) Buccal mucosa and tongue
Figure 4
Figure 4
Clinical photograph revealing angular cheilitis at the right corner of the mouth
See this image and copyright information in PMC

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