[show abstract][hide abstract] ABSTRACT: To assess the periodontal status of HIV positive individuals and to compare it with age-and gender-matched controls.
The cross-sectional study comprised fifty-two HIV positive individuals and fifty-two controls. OHI-S and PI were recorded by a single pre-trained and pre-calibrated examiner.
Based on antiretroviral therapy use, mean OHI-S was higher among HIV positive females undergoing therapy. A significant gender difference was observed in the PI score among those on antiretroviral therapy, with females having a lower score (p = 0.04). Also, significant gender difference was observed in the mean PI score among HIV positive individuals, with males having a higher score.
There was a significant difference in the overall mean OHI-S score among HIV positive individuals and controls (p = 0.03). However, no significant difference was observed when the overall PI score was calculated for both groups (p = 0.95).
[show abstract][hide abstract] ABSTRACT: The objectives of the study are to evaluate the relationship between common HIV-related oral lesions and absolute CD4+ count, age, gender, and medication used and to assess the sensitivity, specificity, positive and negative predictive value of oral manifestations for low absolute CD4+ counts. HIV-positive patients, 200, from south India were selected, whose absolute CD4+ counts were determined within 2 weeks of oral examination. Sociodemographic data was obtained using a structured questionnaire. Oral manifestations were diagnosed according to presumptive criteria of EEC-clearinghouse classification (1993). Four or more concurrent oral lesions were statistically significant with low CD4+ counts <200 cells/mm3 (P = 0.005). The highest and lowest mean CD4+ cell counts were seen in individuals with linear gingival erythema (LGE; 172.5 cells/mm(3)) and pseudomembranous candidiasis (PC; 87 cells/mm(3)), respectively. Smoking, age (<35 years), and males had a positive association with oral hairy leukoplakia (OHL; P < 0.05). Patients with CD4+ counts < 200 cells/mm(3) were associated with 15 times greater risk of PC and four times at greater risk for occurrence of any oral manifestation. Concurrent oral manifestations (>or=4) were good predictors (80-100%) of severe immune suppression. In most resource poor countries where facilities for undertaking CD4+ counts are not available, the presence of concurrent oral manifestations may be used as an indicator of deteriorating immune status.
[show abstract][hide abstract] ABSTRACT: To correlate CD4 cell count with gingival bleeding index in HIV positive individuals.
Fifty-one serologically confirmed HIV positive individuals were included in the study. Plaque index and bleeding index was recorded by a single examiner. CD4 cell count was obtained within 30 days from the day of examination. CD4 cell counts and gingival bleeding index was correlated using Spearman's correlation test. p < 0.01 was considered as statistically significant.
Mean plaque score, mean gingival bleeding index score and mean CD4 cell count was 1.40, 0.96 and 249.86 cells/mm3 respectively. It was noticed that gingival bleeding was enhanced in individuals with increased immunosuppression. However, no significant positive correlation was seen between mean CD4 cell count and gingival bleeding (p = 0.14).
Though CD4 cells are an important indicator for clinical aggravation of HIV infection, periodontal disease as measured by bleeding index is not directly associated to the cell count.
[show abstract][hide abstract] ABSTRACT: To assess types and prevalence of HIV-related oral lesions among HIV-infected individuals in south India and to correlate common oral findings with co-morbidities, gender, age and medication.
One hundred and one patients with HIV infection or AIDS at infectious diseases units of Attavar Hospital, Mangalore, and medical wards of Kasturba Medical College, Manipal, were selected. Sociodemographic information was obtained using a structured questionnaire. Oral lesions were diagnosed according to the presumptive criteria of EEC-Clearinghouse Classification. Clinical history was retrieved from patient's medical records.
Erythematous candidiasis (44.5%), melanotic hyperpigmentaion (34.6%) and xerostomia (29.7%) were among the most common oral manifestations. A significant association was found between oral candidiasis and advanced immunosuppression (P < 0.05). Oral hairy leukoplakia (OHL) was predominant in individuals <35 years (P < 0.05). Melanotic hyperpigmentation was significantly associated with highly active antiretroviral therapy (P < 0.05). OHL was more frequent in patients with HIV-associated tuberculosis. Linear gingival erythema was more predominant in females.
Oral hairy leukoplakia showed a positive relationship with patients younger than 35 years. Oral candidiasis can act as a marker for immunosuppression. Angular cheilitis was predominant in the symptomatic stage.