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Oral Manifestations Associated with HIV/AIDS Patients. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58091214. [PMID: 36143891 PMCID: PMC9504409 DOI: 10.3390/medicina58091214] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 08/01/2022] [Accepted: 08/30/2022] [Indexed: 11/17/2022]
Abstract
Oral manifestations are early and important clinical indicators of Human Immunodeficiency Virus (HIV) infection since they can occur in up to 50% of HIV-infected patients and in up to 80% of patients at the AIDS stage (<200 CD4+ T lymphocytes). Oral health is related to physical and mental well-being because the presence of some lesions can compromise dental aesthetics, and alter speech, chewing, and swallowing, thus impacting the quality of life of patients. For this reason, it is necessary to integrate, as part of the medical treatment of HIV-positive patients, the prevention, diagnosis, and control of oral health. It is essential that health professionals have the power to identify, diagnose, and treat oral pathologies through clinical characteristics, etiological agents, and risk factors, both local and systemic. A diagnosis at an early stage of injury allows optimizing and prioritizing oral treatments, especially in acute pathologies, such as gingivitis and necrotizing periodontitis. In this group of patients, the development of strategies for the prevention, control, and reduction of these pathologies must be prioritized in order to reduce morbidity and mortality in this group of patients.
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Digital Form for Assessing Dentists' Knowledge about Oral Care of People Living with HIV. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095055. [PMID: 35564449 PMCID: PMC9103845 DOI: 10.3390/ijerph19095055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 04/08/2022] [Accepted: 04/10/2022] [Indexed: 12/04/2022]
Abstract
Oral lesions are usually the first sign of HIV infection. The present study aimed to determine the level of the knowledge of dentists on the dental care needs of People Living with HIV (PLWH). This cross-sectional study was conducted between February and May 2021, in the Brazilian state of Pará, during which a total of 51 dentists received an anonymous digital form (Google® Forms Platform) composed of four blocks of discursive, dichotomous, and multiple-choice questions. The questions referred to various aspects of the dental care needs of PLWH, together with data on the professional activities of the dentists. After signing the term of informed consent, the dentists were divided into six subgroups according to the time (in years) since completing their bachelor’s degree in dentistry. The data were presented as descriptive statistics and percentages, and then analyzed using the Kappa test. Most (70.6%; 36 of 51) of the dentists were female, the mean age of the dentists was 32.5 years, and a majority (80.2%) were based in the city of Belem; the mean time since graduation was 8.5 years, with 22 (43.1%) having more than 5 years of professional experience, and 31 (60.8%) having graduated from a private dental college. Just over half (51%) of the 51 dentists had completed graduate courses, and the most common dental specialty was orthodontics (19.6%). Most (74.5%) of the dentists work in the private sector, 38 (74.5%) claimed to have already provided oral care to PLWH, and 43 (84.3%) had access to specialist content on the oral care needs of PLWH. In terms of the knowledge of the dentists with regard to the oral care needs of PLWH, four of the ten diagnostic questions obtained more inadequate answers than expected, whereas the final two questions (11–45.1% and 12–31.4%) demonstrated that many of the dentists adopt unnecessary modifications in their oral care protocol for PLWH, due to a fear of contamination. Overall, our results demonstrate a frequent lack of knowledge, especially with regard to the oral healthcare needs of PLWH, which may account for many of the stigmas that persist in the dental care of this vulnerable group.
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Evaluation of Sociodemographic Factors and Prevalence of Oral Lesions in People Living with HIV from Cacoal, Rondônia, Amazon Region of Brazil. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052614. [PMID: 35270307 PMCID: PMC8909999 DOI: 10.3390/ijerph19052614] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 02/11/2022] [Accepted: 02/16/2022] [Indexed: 12/20/2022]
Abstract
Background: It is necessary to evaluate and understand the prevalence and risk factors of oral lesions (OL) in people living with HIV (PLWH) who were never studied before. The present study aimed to describe the prevalence of OL and its correlation with CD4+ T lymphocytes counts and HIV plasma viral load in PLWH treated in Rondônia. Methods: A cross-sectional study was carried out at Cacoal city, Rondônia state, Northern Brazil. Sociodemographic, epidemiological, immunologic and virological information of 113 PLWH were collected from medical records and dental examination was conducted to diagnose and classify OL in PLWH. Statistical analysis was performed using relative frequency distribution, ANOVA, Kruskal–Wallis, T-student and Mann-Whitney tests. Results: The overall prevalence of oral lesions was 28.3% (32/113), with candidiasis (7/32; 21.8%) and aphthous ulcer (7/32; 21.8%) being the most prevalent. There was a predominance of females, most patients being married, with a low level of education, a family income of 1 to 3 minimum wages and a single partner. An association was observed between the presence of oral lesions and a high viral load, as well as a lower occurrence of oral lesions in individuals with a higher count of CD4+ T cells. Conclusions: This study reveals a low prevalence of OL among PLWH, as well as the absence of relationship between HIV viral load, CD4+ T cells count and OL high prevalence.
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Oral and Maxillo-Facial Manifestations of Systemic Diseases: An Overview. ACTA ACUST UNITED AC 2021; 57:medicina57030271. [PMID: 33809659 PMCID: PMC8002330 DOI: 10.3390/medicina57030271] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 03/12/2021] [Accepted: 03/12/2021] [Indexed: 12/12/2022]
Abstract
Many systemic (infective, genetic, autoimmune, neoplastic) diseases may involve the oral cavity and, more generally, the soft and hard tissues of the head and neck as primary or secondary localization. Primary onset in the oral cavity of both pediatric and adult diseases usually represents a true challenge for clinicians; their precocious detection is often difficult and requires a wide knowledge but surely results in the early diagnosis and therapy onset with an overall better prognosis and clinical outcomes. In the current paper, as for the topic of the current Special Issue, the authors present an overview on the most frequent clinical manifestations at the oral and maxillo-facial district of systemic disease.
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Shu W, Li C, Du F, Bai J, Duan K. A real-world, cross sectional study of oral lesions and their association with CD4 cell counts and HIV viral load in Yunnan, China. Medicine (Baltimore) 2020; 99:e22416. [PMID: 33019418 PMCID: PMC7535679 DOI: 10.1097/md.0000000000022416] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Human immunodeficiency virus (HIV) supresses immune system, primarily cell-mediated immunity. Cluster of differentiation 4 (CD4) cell count, viral load, and oral lesions are the most important laboratory parameters to evaluate the evolution of acquired immunodeficiency syndrome. The present study aims to determine the incidence of HIV-related oral lesions with CD4 cell count and viral load in Yunnan, China.A cross-sectional study was conducted from December 2007 to December 2009, in 1812 HIV positive patients from Department of Infectious Diseases in Kunming Third People's Hospital. CD4, CD8, and viral load data were collected and analyzed statistically using SPSS 11.3.Out of 1812 HIV positive patients, 929 (51.27%) were associated with 1 or more oral lesions. The most common oral lesions observed were Candida Pseudomembranous (13.75%), Candida erythematous (10.93%), Oral hairy leukoplakia (7.95%), Aphthous ulcer (6.18%), Herpes simplex infection (5.58%). In most patients with oral lesions, the CD4 cell count was < 200/μL. The incidence of oral lesions was lower when CD4 count was > 200/μL and with undetectable (P < .01) HIV viral load. Almost no oral lesions was observed when CD4 count > 500/μL (P < .01). With highly active antiretroviral therapy, reduction in HIV-related oral lesions was observed especially in Candida erythematous, Candida Pseudomembranous, Oral hairy leukoplakia, and Aphthous ulcer.The higher incidence of oral lesions with lower CD4 count (<200/μL) in HIV-infected patients indicated importance of CD4 cell count in identifying disease progression.
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Affiliation(s)
- Wen Shu
- Department of Stomatology, Kunming Medical University Yan An Hospital and Yan An Hospital of Kunming City
| | - Chengwen Li
- Department of Research Management, The third affiliated hospital of Kunming Medical University
| | - Fei Du
- Department of Stomatology, Kunming Medical University Yan An Hospital and Yan An Hospital of Kunming City
| | - Jinsong Bai
- Department of Infectious Diseases, Kunming Third People's Hospital, Kunming, China
| | - Kaiwen Duan
- Department of Stomatology, Kunming Medical University Yan An Hospital and Yan An Hospital of Kunming City
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Chakraborty R, Sen S. Stomatognathic manifestations of human immunodeficiency virus-infected patients: A case report and review. Indian J Sex Transm Dis AIDS 2020; 40:172-175. [PMID: 31922110 PMCID: PMC6896377 DOI: 10.4103/ijstd.ijstd_100_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Oral lesions in the stomatognathic system in human immunodeficiency virus (HIV)-infected patients are associated with a series of opportunistic disease that are caused due to immune suppressive state. Oral manifestations are the earliest sign of HIV infection. Here, we are reporting a case of a patient suffering from HIV infection with typical oral manifestations and the effect of treatment for the manifestations after a week. The patient was under highly active anti-retroviral treatment since 2011.
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Affiliation(s)
- Rakashree Chakraborty
- Department of Oral Medicine and Radiology, Maharishi Markandeshwar College of Dental Sciences and Research (Deemed to be University), Ambala, Haryana, India
| | - Sourav Sen
- Public Health Dentistry, Maharishi Markandeshwar College of Dental Sciences and Research (Deemed to be University), Ambala, Haryana, India
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Sridevi K, Malathi S, Kv C, G CN, Gayathri M, Chand GE, Nayyar AS. CD4 Cell Counts, Lipid Profile, and Oral Manifestations in HIV-Infected and AIDS Patients. Front Dent 2019; 16:436-449. [PMID: 33089245 PMCID: PMC7569270 DOI: 10.18502/fid.v16i6.3443] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 10/01/2019] [Indexed: 11/24/2022] Open
Abstract
Objectives The present study aimed to evaluate CD4 cell counts, lipid profile, and oral manifestations in human immunodeficiency virus (HIV)-infected and acquired immune deficiency syndrome (AIDS) patients and their correlation with seronegative controls. Materials and Methods In this cross-sectional, hospital-based study, there were three groups of subjects: group A consisting of 500 healthy patients (controls), group B composed of 500 HIV-infected patients, and group C comprised of 500 AIDS patients based on their CD4 cell counts. CD4 cell counts were assessed using the CyFlow counter. Lipid profile was evaluated with the Erba EM 360 analyzer. Results The results were statistically significant for CD4 cell counts (P<0.001). The levels of total cholesterol (TC) and low-density lipoproteins (LDLs) were significantly decreased while triglycerides (TGs) and very-low-density lipoproteins (VLDLs) were significantly increased in AIDS patients compared to the controls and HIV-infected patients. Various results were obtained regarding oral manifestations with different levels of significance. Conclusion CD4 cell counts, TC, LDLs, TGs, and VLDLs were significantly changed in HIV-infected and AIDS patients compared to the controls.
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Affiliation(s)
- Koduri Sridevi
- Department of Oral Medicine and Radiology, Lenora Institute of Dental Sciences, Rajahmundry, Andhra Pradesh, India
| | - Saka Malathi
- Department of Oral Medicine and Radiology, Army College of Dental Sciences, Secunderabad, Telangana, India
| | - Chalapathi Kv
- Department of Oral Pathology and Microbiology, Care Dental College and Hospital, Guntur, Andhra Pradesh, India
| | - Chowdary Nagarjuna G
- Department of Pedodontics and Preventive Dentistry, MNR Dental College and Hospital, Sangareddy, Telangana, India
| | - M Gayathri
- Department of Oral Medicine and Radiology, Adhiparasakthi Dental College and Hospital, Melmaruvathur, Tamilnadu, India
| | - G Eswar Chand
- Medical Graduate, Mamata Medical College, Khammam, Telangana, India
| | - Abhishek Singh Nayyar
- Department of Oral Medicine and Radiology, Saraswati Dhanwantari Dental College and Hospital and Post-graduate Research Institute, Parbhani, Maharashtra, India
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Jampani ND, Sunkavilli RK, Songa VM, Buggapati L, Pathagunti SR. Periodontal health status among HIV-seropositive pregnant women. Indian J Dent Res 2019; 30:521-526. [PMID: 31745046 DOI: 10.4103/ijdr.ijdr_144_16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Aims and Objective Routine oral health care is essential for those living with HIV (human immunodeficiency virus) infection, especially in pregnant women. Hormonal changes during pregnancy, immunosupression in HIV along with bacterial load in periodontal infections strongly influence the pregnancy outcomes. The aim of this study was to evaluate the periodontal health status in HIV seropositive pregnant women in Andhra Pradesh, India. Materials and Methods This study includes a sample of 90 divided into three groups; HIV seropositive pregnant women (group PH; n = 30), HIV seropositive nonpregnant women (group H; n = 30), and healthy pregnant women without HIV infection (group P; n = 30). Clinical examination includes the recording of probing depths (PD), clinical attachment level (CAL), plaque index (PI), gingival index (GI), and periodontal screening and recording index (PSR) were assessed in three groups. Statistical analysis was done by Mann-Whitney U-test and Wilcoxon paired test using the software SPSS version 17. Results Clinical parameters do not show any significant variation between the three groups. But slightly higher mean PD and CAL levels was observed in HIV seropositive pregnant and nonpregnant women compared with healthy pregnant women without HIV infection. About 13% of severe gingivitis cases were observed in HIV seropositive pregnant group compared with 6% in HIV seropositive and 3% in healthy pregnant group. Conclusions Presence of slightly higher percentage of severe gingivitis in HIV seropositive pregnant women strengthens the fact of extra need for preventive oral health services during the prenatal period and provides recommendations for promoting maternal oral health in regional antiretroviral therapy centers in India.
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Affiliation(s)
- Narendra Dev Jampani
- Department of Periodontics, Dr. NTR University of Health Sciences, Government Dental College and Hospital, Vijayawada, Andhra Pradesh, India
| | - Ravi Kiran Sunkavilli
- Department of Periodontics, Dr. NTR University of Health Sciences, Government Dental College and Hospital, Vijayawada, Andhra Pradesh, India
| | - Vajra Madhuri Songa
- Department of Periodontics, Dr. NTR University of Health Sciences, Government Dental College and Hospital, Vijayawada, Andhra Pradesh, India
| | - Lahari Buggapati
- Department of Periodontics, Dr. NTR University of Health Sciences, Government Dental College and Hospital, Vijayawada, Andhra Pradesh, India
| | - Srinivasa Reddy Pathagunti
- Department of Periodontics, Dr. NTR University of Health Sciences, Government Dental College and Hospital, Vijayawada, Andhra Pradesh, India
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Vohra P, Jamatia K, Subhada B, Tiwari RVC, Althaf MSN, Jain C. Correlation of CD4 counts with oral and systemic manifestations in HIV patients. J Family Med Prim Care 2019; 8:3247-3252. [PMID: 31742150 PMCID: PMC6857402 DOI: 10.4103/jfmpc.jfmpc_767_19] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 09/16/2019] [Accepted: 09/23/2019] [Indexed: 11/04/2022] Open
Abstract
AIM Aim of the study was to correlate CD4 counts with oral and systemic manifestations in HIV patients. MATERIALS AND METHODS Study population comprised of newly diagnosed 100 confirmed seropositive patients, before starting any antiretroviral therapy, were included. The oral lesions were diagnosed based on clinical manifestation using international criteria and CD4 count was determined within maximum 1 week of oral examination. Oral and systemic manifestations of HIV-positive patients were recorded and correlated with CD4 counts. RESULTS It was found that decrease in CD4 count is associated with a wide range of oral and systemic manifestations which can be used as prognostic marker for immune suppression in AIDS patient. CONCLUSION Correlation of CD4 count with oral and systemic manifestation in HIV patient demonstrate the role of oral physician in identification, diagnosis, and treatment of HIV-associated lesions, providing proper guidance to the patient and allowing for an early diagnosis and treatment of the disease, which is fundamental for a successful management of the life conditions of HIV infected patients.
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Affiliation(s)
- Puneeta Vohra
- Department of Oral Medicine and Radiology, Faculty of Dental Sciences, SGT University, Gurgaon, Haryana, India
| | - Kahamnuk Jamatia
- Department of Dentistry, AGMC and GBP Hospital, Agartala, Tripura, India
| | - B Subhada
- Department of Periodontics, Sri Sai College of Dental Surgery, Vikarabad, Telangana, India
| | - Rahul Vinay Chandra Tiwari
- Department of Oral and Maxillofacial Surgery, Sri Sai College of Dental Surgery, Vikarabad, Telangana, India
| | - MS Nabeel Althaf
- Department of Periodontology, Kavil's Smiley Multi Specialty Dental Clinic, Uppala, Kasaragod, Kerala, India
| | - Chayan Jain
- Department of Pedodontics and Preventive Dentistry, Maharana Pratap College of Dentistry and Research Centre, Gwalior, Madhya Pradesh, India
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El Howati A, Tappuni A. Systematic review of the changing pattern of the oral manifestations of HIV. ACTA ACUST UNITED AC 2018; 9:e12351. [PMID: 30019446 DOI: 10.1111/jicd.12351] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 04/20/2018] [Indexed: 11/27/2022]
Abstract
The purpose of the present study paper was to review the reported prevalence of the oral manifestations of HIV (OM-HIV) worldwide since 1980, and to determine the global variation in its prevalence over time. PubMed, Scopus, Embase and Google Scholar were searched. The filter "English" was used. The timeframe searched was 1980- 2015. The PRISMA flow chart was used. Data were extracted using the Joanna Briggs Institute standardized data extraction form and transferred to SPSS version 22 for analysis. The systematic review of 97 studies (70 low bias risk) showed that the prevalence of OM-HIV continue to be significant in developing countries. Globally and through all the decades, oral candidiasis remained the most commonly encountered OM-HIV, including among patients on antiretroviral therapy (ART) (26.2%). Hairy leukoplakia was more prevalent in Europe and America compared with Africa and Asia. Oral warts were reported more often in studies on patients receiving ART. Interestingly, salivary gland disease decreased in the developed world and increased in developing countries over time. Despite the changing pattern of these conditions over time, there is no evidence that the OM-HIV have become of less significance globally. Maintaining the drive for high-quality research in the subject will have an impact on less developed countries to help address oral health inequalities.
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Affiliation(s)
- Asma El Howati
- Department of Oral Medicine, Institute of Dentistry, Queen Mary University of London, London, UK.,Department of Oral Medicine, Faculty of Dentistry, Benghazi (Garyounis) University, Benghazi, Libya.,Department of Oral Medicine and Oral Surgery, Faculty of Dentistry, Libyan International Medical University, Benghazi, Libya
| | - Anwar Tappuni
- Department of Oral Medicine, Institute of Dentistry, Queen Mary University of London, London, UK
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Ratnam M, Nayyar AS, Reddy DS, Ruparani B, Chalapathi KV, Azmi SM. CD4 cell counts and oral manifestations in HIV infected and AIDS patients. J Oral Maxillofac Pathol 2018; 22:282. [PMID: 30158790 PMCID: PMC6097352 DOI: 10.4103/jomfp.jomfp_191_17] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Context Acquired immunodeficiency syndrome (AIDS) is an acronym for AIDS caused by a retrovirus known as human immunodeficiency virus (HIV) which breaks down the body's immune system leaving a patient vulnerable to a host of life-threatening opportunistic infections, neurological disorders or unusual malignancies. According to estimates by the World Health Organization and UNAIDS, 35 million people were living with HIV globally at the end of 2013. The first AIDS case in India was detected in 1986. Seldom studies have been conducted correlating these parameters with oral manifestations in the Indian population. Aim The present study was carried out to evaluate the CD4 cell counts and oral manifestations in HIV-infected and AIDS patients and to correlate them with the seronegative controls. Methodology This was a cross-sectional, hospital-based study on individuals who were divided into three groups, Group A consisting of 500 patients who were healthy controls without any systemic illness; Group B consisting of 500 patients who were diagnosed as HIV infected and Group C consisting of 500 patients diagnosed as AIDS patients depending on their CD4 cell counts. The permission from the Ethical Committee of the Institution as well as Superintendent of Government Hospital was obtained. Evaluation of CD4 cell counts in HIV-infected and AIDS patients was done using CyFlow Counter. Results The results were found to be statistically significant with the P < 0.001 for the CD4 cell counts. Oral manifestations revealed varied results with different levels of significance. Conclusion CD4 cell counts were significantly altered in HIV-infected and AIDS patients when compared with the controls while oral manifestations revealed varied results with different levels of significance.
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Affiliation(s)
- Mvr Ratnam
- Department of Oral Medicine and Radiology, Sri Sai Dental College and Research Institute, Srikakulam, India
| | - Abhishek Singh Nayyar
- Department of Oral Medicine and Radiology, Saraswati-Dhanwantari Dental College and Hospital and Post-Graduate Research Institute, Parbhani, Maharashtra, India
| | - D Santhosh Reddy
- Department of Oral Pathology and Microbiology, Aditya Dental College and Hospital, Beed, Maharashtra, India
| | - B Ruparani
- Department of Periodontology and Implantology, MNR Dental College and Hospital, Sangareddy, Telangana, India
| | - K V Chalapathi
- Department of Oral Pathology and Microbiology, Care Dental College and Hospital, Guntur, Andhra Pradesh, India
| | - Sania Md Azmi
- Department of Oral Pathology and Microbiology, Care Dental College and Hospital, Guntur, Andhra Pradesh, India
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Satyakiran GVV, Bavle RM, Alexander G, Rao S, Venugopal R, Hosthor SS. A relationship between CD4 count and oral manifestations of human immunodeficiency virus-infected patients on highly active antiretroviral therapy in urban population. J Oral Maxillofac Pathol 2016; 20:419-426. [PMID: 27721607 PMCID: PMC5051290 DOI: 10.4103/0973-029x.190934] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
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.
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Affiliation(s)
| | - Radhika Manoj Bavle
- Department of Oral and Maxillofacial Pathology, Krishnadevaraya College of Dental Sciences, Bangalore, Karnataka, India
| | - Glory Alexander
- Managing Director, Asha Foundation, Indiranagar, Bangalore, Karnataka, India
| | - Saritha Rao
- Consultant Peadiatrician, Asha Foundation, Indiranagar, Bangalore, Karnataka, India
| | - Reshma Venugopal
- Department of Oral and Maxillofacial Pathology, Krishnadevaraya College of Dental Sciences, Bangalore, Karnataka, India
| | - Sreelatha S Hosthor
- Department of Oral and Maxillofacial Pathology, Krishnadevaraya College of Dental Sciences, Bangalore, Karnataka, India
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Pakfetrat A, Falaki F, Delavarian Z, Dalirsani Z, Sanatkhani M, Zabihi Marani M. Oral manifestations of human immunodeficiency virus-infected patients. IRANIAN JOURNAL OF OTORHINOLARYNGOLOGY 2015; 27:43-54. [PMID: 25745611 PMCID: PMC4344974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/12/2014] [Accepted: 05/08/2014] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Oral lesions are among the earliest clinical manifestations of human immunodeficiency (HIV) infection and are important in early diagnosis and for monitoring the progression to acquired immunodeficiency syndrome (AIDS). The purpose of this study was to determine the prevalence of oral lesions and their relationship with a number of factors in HIV/AIDS patients attending an HIV center. MATERIALS AND METHODS A total of 110 HIV-positive patients were examined to investigate the prevalence of oral lesions according to the criteria established by the European Community Clearing House on Oral Problems Related to HIV Infection. An independent T-test was used for correlation of oral lesions with CD4+ count and a χ2 test was used for analysis of the relationship of co-infection with hepatitis B virus (HBV), sexual contact, route of transmission, history of drug abuse, and history of incarceration. RESULTS Most of the cases were male patients (82.7%). The mean age across all participants was 36.2±8.1 years. Rampant carries, severe periodontitis and oral candidiasis were the most notable oral lesions. Oral lesions were more prevalent in patients between 26-35 years of age. There was a significant difference between patients with and without pseudomembranous candidiasis and angular cheilitis according to mean level of CD4+. CONCLUSION The most common oral presentations were severe periodontitis, pseudomembranous candidiasis and xerostomia.
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Affiliation(s)
- Atessa Pakfetrat
- Oral and Maxillofacial Diseases Research Center, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Farnaz Falaki
- Oral and Maxillofacial Diseases Research Center, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Zahra Delavarian
- Oral and Maxillofacial Diseases Research Center, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Zohreh Dalirsani
- Dental Research Center, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran.,Corresponding Author: Vakilabad Blvd, Postal code: 91735, Mashhad, Iran. E-mail:
| | - Majid Sanatkhani
- Oral and Maxillofacial Diseases Research Center, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran.
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Soares GB, Garbin CAS, Moimaz SAS, Garbin AJÍ. Oral health status of people living with HIV/AIDS attending a specialized service in Brazil. SPECIAL CARE IN DENTISTRY 2013; 34:176-84. [DOI: 10.1111/scd.12056] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Gabriella Barreto Soares
- Master Programme in Preventive and Social Dentistry; Araçatuba Dental School; Estadual Paulista University; Unesp Araçatuba Brazil
| | - Cléa Adas Saliba Garbin
- Coordinator of Postgraduate Programme in Preventive and Social Dentistry; Araçatuba Dental School, Estadual Paulista University; Unesp Araçatuba Brazil
| | - Suzely Adas Saliba Moimaz
- Full Professor, Preventive and Social Dentistry Postgraduate Programme; Araçatuba Dental School, Estadual Paulista University; Unesp Araçatuba Brazil
| | - Artênio José Ísper Garbin
- Associate Professor, Preventive and Social Dentistry Postgraduate Programme; Araçatuba Dental School, Estadual Paulista University; Unesp Araçatuba Brazil
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Gonçalves LS, Júnior AS, Ferreira SMS, Sousa CO, Fontes TV, Vettore MV, Torres SR. Factors associated with specific clinical forms of oral candidiasis in HIV-infected Brazilian adults. Arch Oral Biol 2012; 58:657-63. [PMID: 23123068 DOI: 10.1016/j.archoralbio.2012.10.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2012] [Revised: 09/28/2012] [Accepted: 10/06/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVE This study assesses the association among factors related with specific clinical forms of oral candidiasis (OC) in HIV-infected Brazilian adults. DESIGN This study was conducted with 590 HIV-infected adults from 1997 to 2004. The OC diagnosis was based in accordance with the EC-Clearinghouse classification. Multivariate logistic regression analyses were performed to measure the association between HAART and OC, with pseudomembranous [PC], erythematous [EC], and angular cheilitis [AC]) adjusted for HIV-related diseases, smoking, alcohol consumption, injecting and non-injecting drug use. RESULTS Two hundred and eighteen (37.0%) individuals were undergoing HAART. The prevalence of PC, EC and AC was 21.2%, 15.7% and 8.8%, respectively. Approximately 64% of the individuals with PC and EC, and 76.5% with AC had absolute CD4 levels ≤200cells/mm(3). The results of the multivariate analysis showed that subjects not undergoing HAART had a significantly higher odds ratio for PC [OR 3.67 (95% CI: 1.97-6.80)] and EC [OR 1.88 (95% CI: 1.04-3.39)], and AC [OR 4.56 (95% CI: 1.58-13.19)]. In addition, smoking [OR 2.58 (95% CI: 1.43-4.68)] and pneumocystis pneumonia [OR 1.92 (95% CI: 1.07-3.42)] were associated with PC, while high alcohol consumption [OR 3.40 (95% CI: 1.13-10.18)] and cytomegalovirus infection [OR 2.34 (95% CI: 1.06-5.15)] were associated with EC. CONCLUSION The data indicates that the odds of having all clinical forms of OC are higher in HIV-infected adults not receiving HAART.
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Perera M, Tsang PCS, Samaranayake L, Lee MP, Li P. Prevalence of oral mucosal lesions in adults undergoing highly active antiretroviral therapy in Hong Kong. ACTA ACUST UNITED AC 2012; 3:208-14. [DOI: 10.1111/j.2041-1626.2012.00124.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Prevalence of Oral Manifestations and Their Association with CD4/CD8 Ratio and HIV Viral Load in South India. Int J Dent 2011; 2011:964278. [PMID: 22046186 PMCID: PMC3199184 DOI: 10.1155/2011/964278] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2011] [Accepted: 08/22/2011] [Indexed: 11/17/2022] Open
Abstract
The objective of the present research was to determine the prevalence of oral manifestations in an HIV infected population from south India and evaluate their association with HIV viral load and CD4/CD8 ratio. Intraoral examination of 103 patients, whose CD4/CD8 ratio was available, were conducted. HIV viral loads were available for thirty patients only. The prevalence of oral manifestations was 80.6% (83/103). The most common oromucosal lesion was erythematous candidiasis (EC) (38.8%) followed by melanotic hyperpigmentation (35.9%). Patients having any oral manifestation had a mean CD4/CD8 ratio of 0.24. EC had positive predictive value of 85.0% for CD4/CD8 ratio <0.30. The prevalence of oral manifestations in patients taking ART was lesser (78.6%) as compared to patients not taking ART (82%). Patients having any oral manifestation had a higher HIV viral load as compared to patients not having any oral manifestations (P < 0.05). Pseudomembranous candidiasis (PC) was significantly associated with higher HIV viral loads (>20,000 copies/mL) (P < 0.05). Patients having EC had 4 times greater chance of having CD4/CD8 ratio <0.30. PC can be considered as a marker of immune suppression (HIV viral load >20,000 copies/mL).
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Lourenço AG, Motta ACF, Figueiredo LTMD, Machado AA, Komesu MC. Oral lesions associated with HIV infection before and during the antiretroviral therapy era in Ribeirão Preto, Brazil. J Oral Sci 2011; 53:379-85. [DOI: 10.2334/josnusd.53.379] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Davoodi P, Hamian M, Nourbaksh R, Ahmadi Motamayel F. Oral Manifestations Related To CD4 Lymphocyte Count in HIV-Positive Patients. J Dent Res Dent Clin Dent Prospects 2010; 4:115-9. [PMID: 23346337 PMCID: PMC3429960 DOI: 10.5681/joddd.2010.029] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2010] [Accepted: 11/04/2010] [Indexed: 11/17/2022] Open
Abstract
Background and aims
The onset of opportunistic infections in HIV-positive patients is generally associated with a low CD4 count. Oral manifestations can be the first clinical sign of the infection and also determine the progression of disease. The purpose of this study was to determine the prevalence of oral soft tissue manifestations and their relationship with the degree of immunosuppression observed in HIV-positive patients.
Materials and methods
100 HIV-positive patients were examined. Oral lesions were evaluated according to EEC clearing house criteria. The degree of immunosuppression was based on the CD4 count closest to the oral examination. Data were analyzed using Student’s t-test and chi-square test.
Results
The most common oral lesions were rampant caries (54%), periodontal disease (44%), and hyperpigmentation (42%). Salivary glands enlargements and leukoplakia were associated with more severe immunosuppression.
Conclusion
According to the results, it seems that occurrence of only some of oral lesions are related to the degree of immunosuppression and such lesions can be considered as indicators of the progression of the HIV infection.
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Affiliation(s)
- Poorandokht Davoodi
- Assistant Professor, Department of Oral Medicine, Dental School, Hamadan University of Medical Sciences, Hamadan, Iran
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Moura MDG, Haddad JPA, Senna MIB, Ferreira e Ferreira E, Mesquita RA. A new topical treatment protocol for oral hairy leukoplakia. ACTA ACUST UNITED AC 2010; 110:611-7. [PMID: 20813564 DOI: 10.1016/j.tripleo.2010.05.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2009] [Revised: 05/11/2010] [Accepted: 05/15/2010] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The aim of this study was to present a new topical treatment protocol for oral hairy leukoplakia (OHL), consisting of a 25% podophyllin resin with a 1% penciclovir cream (PP), and to compare this topical treatment protocol's efficacy with that of 2 other topical treatment protocols: a 25% podophyllin resin (P) and a 25% podophyllin resin with a 5% acyclovir cream (PA). STUDY DESIGN Forty-two human immunodeficiency virus-positive patients with 69 OHL lesions were randomly treated using P, PA, or PP (14 patients in each topical treatment protocol). Clinical healing was determined when the white plaque could no longer be seen in the primary location of the lesion. Topical treatment performance was evaluated by clinical healing within each week of topical treatment protocol as well as by the recurrence of the lesion. Statistical survival analysis was performed using a Cox proportional hazards model. RESULTS Approximately 55% of the patients presented with clinical healing of OHL within 7-8 weeks of each topical treatment protocol. After the sixth week, the PA treatment protocol presented a faster clinical healing rate of OHL. Recurrence was observed in 3 and 7 OHL lesions treated with P and PP treatment protocols, respectively. CONCLUSIONS The PP treatment protocol proved to be effective; however, the PA treatment protocol was more effective in the clinical healing rate for OHL than P and PP after the sixth week of treatment, and no recurrent OHL was observed in the PA treatment group.
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Affiliation(s)
- Mariela Dutra Gontijo Moura
- Department of Oral Surgery, Oral Medicine and Oral Pathology, School of Dentistry, Universidade Federal de Minas Gerais and Centro de Treinamento e Referência em Doenças Infecciosas e Parasitárias Orestes Diniz, Belo Horizonte, Brazil
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