J Korean Assoc Oral Maxillofac Surg.  2017 Feb;43(1):29-36. 10.5125/jkaoms.2017.43.1.29.

Oral manifestations and their correlation to baseline CD4 count of HIV/AIDS patients in Ghana

• Frimpong P
• Amponsah E
• Abebrese J
• Kim SM

• KMID: 2385067
• DOI: http://doi.org/10.5125/jkaoms.2017.43.1.29

Abstract

OBJECTIVES
Acquired immunodeficiency syndrome (AIDS) is a disease of the human immune system caused by the human immunodeficiency virus (HIV). People with AIDS are much more vulnerable to infections, including opportunistic infections and tumors, than people with a healthy immune system. The objective of this study was to correlate oral lesions associated with HIV/AIDS and immunosuppression levels by measuring clusters of differentiation 4 (CD4) cell counts among patients living in the middle western regions of Ghana.
MATERIALS AND METHODS
A total of 120 patients who visited the HIV clinic at the Komfo Anokye Teaching Hospital and the Regional Hospital Sunyani of Ghana were consecutively enrolled in this prospective and cross-sectional study. Referred patients' baseline CD4 counts were obtained from medical records and each patient received an initial physician assessment. Intraoral diagnoses were based on the classification and diagnostic criteria of the EEC Clearinghouse, 1993. After the initial assessment, extra- and intraoral tissues from each enrolled patient were examined. Data analyses were carried out using simple proportions, frequencies and chi-square tests of significance.
RESULTS
Our study included 120 patients, and was comprised of 42 (35.0%) males and 78 (65.0%) females, ranging in age from 21 to 67 years with sex-specific mean ages of 39.31 years (males) and 39.28 years (females). Patient CD4 count values ranged from 3 to 985 cells/mL with a mean baseline CD4 count of 291.29 cells/mL for males and 325.92 cells/mL for females. The mean baseline CD4 count for the entire sample was 313.80 cells/mL. Of the 120 patients we examined, 99 (82.5%) were observed to have at least one HIV-associated intraoral lesion while 21 (17.5%) had no intraoral lesions. Oral candidiasis, periodontitis, melanotic hyperpigmentation, gingivitis and xerostomia were the most common oral lesions.
CONCLUSION
From a total of nine oral lesions, six lesions that included oral candidiasis, periodontitis, melanotic hyperpigmentation, gingivitis, xerostomia and oral hairy leukoplakia were significantly correlated with declining CD4 counts.

Keyword

Oral manifestations; HIV; Acquired immune deficiency syndrome; Cluster of differentiation 4 (CD4) cells

MeSH Terms

Acquired Immunodeficiency Syndrome
Candidiasis, Oral
CD4 Lymphocyte Count*
Cell Count
Classification
Cross-Sectional Studies
Diagnosis
European Union
Female
Ghana*
Gingivitis
HIV
Hospitals, Teaching
Humans
Hyperpigmentation
Immune System
Immunosuppression
Leukoplakia, Hairy
Male
Medical Records
Opportunistic Infections
Oral Manifestations*
Periodontitis
Prospective Studies
Statistics as Topic
Xerostomia

Figure

• 

  Fig. 1 Relationship between oral lesions and the mean baseline clusters of differentiation 4 (CD4) count.

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