Epidemiological and oral manifestations of HIV-positive patients in a specialized service in Brazil

Abstract

The purpose of this study was to evaluate the prevalence of oral lesions in HIV-positive patients attending the Specialized Service for Infectious-contagious Diseases and Parasitoses of the Health Secretariat of the State of Pará (URE-DIPE/SESPA), in the city of Belém, PA, Brazil. A total of 79 HIV-positive patients (53 males and 26 females) were examined. Clinical and epidemiological evaluations were done by correlating the lesions with gender, race, chronological age, risk behavior and prevailing immune status (CD4+ cells count). Lesion location and the presence of associated factors, such as alcohol use, smoking and denture wearing, were quantified individually for each type of lesion using a diagnostic pattern based on the clinical aspects. Approximately 47% of the patients (n=37) presented some type of oral lesion. Candidiasis (28%) and periodontal disease (28%) were the most common, followed by cervical-facial lymphadenopathy (17.5%). Other lesions observed were hairy leukoplakia, melanin hyperpigmentation, ulcerative stomatitis (aphthous), herpes simplex, frictional keratosis and pyogenic granuloma. This analysis presented some relevance as to the statistical data. Concerning CD4+ cells, most lesions manifested with the reduction of the CD count. There were a larger number of HIV-positive female heterosexual patients. Alcohol and/or smoking were strongly associated with the occurrence of hairy leukoplakia in these patients. Candidiasis and periodontal disease were the most common oro-regional clinical manifestations in the patients.

Correlation between oral lesions and opportunistic infections among human immunodeficiency virus — infected individuals in Indian population

“…Oral hairy leukoplakia was observed in 24.6% patients. This figure is higher to studies conducted by Laurenco and Figueiredo (11.8%) and Pedreira et al (9%) [20][21][22]. Previous studies, however, reported pseudomembranous candidiasis as the most common oral manifestation [23].…”

Oral Health-Related Quality of Life Among People Living with HIV/AIDS

“…While the symptoms of HIV vary according to the stage of infection, studies have shown that health-related QOL (HRQOL) of PLWHA declines as the disease progresses and as the number of symptoms increase (Hays et al, 2000;Lorenz et al, 2006;Lorenz et al, 2001). In view of the fact that oral manifestations are among the most common symptoms of HIV which may provide strong indication of the disease progress (Bravo et al, 2006;Greenspan et al, 2000;Lewis et al, 2003 ;Patton, 2000;Pedreira et al, 2008), the presence of oral lesions can therefore have significant impact on the general well-being of individuals affected (Lorenz et al, 2001). Coulter et al (2002) conducted a longitudinal study to determine the association between self-perceived oral health and general health in a sample of adults receiving medical care for HIV in the United States.…”

Prevalence of oral lesions in HIV infected adult population of Mangalore, Karnataka, India

“…Antiretroviral medications can only control the progression rate of disease [2][3][4]. Oral manifestations of HIV infection are important in the AIDS epidemic and some of them could be used to assess the status of immune-suppression and determine the prognosis of the disease [5].…”

“…Reduction of circulating CD4 count is the main criteria for assessing the immunosuppression status in HIV-positive patients. The normal number of circulating CD4 cells ranges from 600 to 1600 cells/ mm³, but the initial signs of immunosuppression occur when CD4 count is lower than 500 cells/mm 3 . WHO proposed the immunological classification on the basis of CD4 count as none or not significant -Group 1 (>500/ ml), mild -Group 2 (350-499/ml), advanced -Group 3 (200-349/ml) and severe -Group 4 (<200/ml).…”