HIV-associated oral lesions: prevalence in Zambia

Abstract

Objectives: To describe the prevalence of HIV-associated oral lesions in known HIV+ subjects in Zambia and assess the predictive value of these lesions to identify individuals with CD4 cell counts less than 200 x 10(6) L-1.

Setting: St Francis Hospital, situated in the rural Katete District, Eastern Province, Zambia.

Subjects: 107 newly diagnosed heterosexual HIV positive individuals included 42% males and 58% females (mean age 34.5, range 16-62).

Methods: Following a medical history and detailed oral examination, blood and whole saliva were collected in each subject.

Results: A total of 47.7% from this sample had an AIDS diagnosis. The mean CD4 count was 252.2 cells mm-3 (s.d. +/- 160.5, range 44-810); 40.2% of the study group demonstrated oral lesions associated with HIV seropositivity. Candidiasis was most commonly seen (25% prevalence). In this population erythematous candidiasis was the only oral lesion significantly associated with CD4 counts of less than 200 x 10(6) L-1 (P < 0.05, Two-tailed Fisher's Exact Test).

Conclusion: In resource poor countries a thorough oral examination may suggest HIV infection and predict disease progression. Health care professional education regarding the orofacial manifestations of HIV infection needs urgent reinforcement in these areas.