J Korean Assoc Oral Maxillofac Surg.  2017 Dec;43(6):388-394. 10.5125/jkaoms.2017.43.6.388.

Oral lesions associated with human immunodeficiency virus in 75 adult patients: a clinical study

• Berberi A
• Aoun G

• KMID: 2398993
• DOI: http://doi.org/10.5125/jkaoms.2017.43.6.388

Abstract

OBJECTIVES
The objective of this study was to investigate the presence of oral lesions in human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients in a descriptive cross-sectional study, and to establish their presence according to levels of CD4+ cells (including the CD4+/CD8+ cell ratio).
MATERIALS AND METHODS
A total of 75 patients infected with HIV were included. Oral lesions were observed and classified using World Health Organization classification guidelines. Potential correlations between the presence and severity of oral lesions and CD4+ cells, including the CD4+/CD8+ cell ratio, were studied.
RESULTS
The most frequent oral lesion detected was oral pseudomembranous candidiasis (80.0%), followed by periodontal disease (40.0%), herpetic lesions (16.0%), hairy leukoplakia (16.0%), gingivitis (20.0%), oral ulceration (12.0%), Kaposi's sarcoma (8.0%), and non-Hodgkin's lymphoma (4.0%). The CD4+ count was <200 cells/mm³ in 45 cases (60.0%), between 200-500 cells/mm³ in 18 cases (24.0%), and >500 cells/mm³ in 12 cases (16.0%). The mean CD4+ count was 182.18 cells/mm³. The mean ratio of CD4+/CD8+ cells was 0.26. All patients showed at least one oral manifestation.
CONCLUSION
There was no correlation between the CD4+/CD8+ cell ratio and the presence of oral lesions. The severity of the lesions was more pronounced when the CD4+ cell count was less than 200 cells/mm³.

Keyword

Acquired immunodeficiency syndrome; CD4+; HIV; Oral lesions

MeSH Terms

Acquired Immunodeficiency Syndrome
Adult*
Candidiasis
CD4 Lymphocyte Count
Classification
Clinical Study*
Cross-Sectional Studies
Gingivitis
HIV*
Humans*
Leukoplakia, Hairy
Lymphoma, Non-Hodgkin
Oral Manifestations
Oral Ulcer
Periodontal Diseases
Sarcoma, Kaposi
World Health Organization

Figure

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  Fig. 1 Distribution by gender and way of contamination.

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  Fig. 2 Distribution of CD4+ cells, CD8+ cells, and the CD4+/CD8+ cell ratio.

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  Fig. 3 Distribution of oral lesions and CD4+ cell counts. (OPC: oral pseudomembranous candidiasis, PD: periodontal disease, HL: herpetic lesions, HLP: hairy leukoplakia, G: gingivitis, OU: oral ulceration, KS: Kaposi's sarcoma, NHL: non-Hodgkin's lymphoma)

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  Fig. 4 Clinical appearance of oral lesions. A. Pseudomembranous candidiasis of the tongue. B. Swelling and redness of the gums as a clinical sign of periodontal disease. C. Herpetic lesion-type vesicles on the lower lip.

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  Fig. 5 A. Hairy leukoplakia of the lateral border of the tongue. B. Ulcerous-necrotic material of the gums as a clinical sign of gingivitis. C. Ulcerations localized on the uvula and the lateral walls of the tonsils.

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  Fig. 6 A. Bilateral, dark purple tumor in the internal part of the palatal area, representing Kaposi's sarcoma. B. Localized tumefaction of the papillae, diagnosed as Kaposi's sarcoma.

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  Fig. 7 Tumefaction in a palatal position with maxillary tooth displacement, revealed by biopsy to be non-Hodgkin's lymphoma.

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  Fig. 8 Distribution of oral pseudomembranous candidiasis types. (P: pseudomembranous, E: erythematous, AC: angular cheilitis)

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