Prevalence of HIV related oral lesions in people living with HIV and on combined antiretroviral therapy: a Nigerian experience

Abstract

Introduction oral lesions comprise significant clinical features of HIV infection and are often indicators of immune suppression. However, the advent of antiretroviral therapy has significantly reduced its prevalence. The aim of this study was to relate the prevalence of oral lesions of HIV to treatment outcome of Combined Antiretroviral Therapy (cART) in a Nigerian HIV adult population. Methods a cross- sectional study was conducted on 491 People Living with HIV (PLWHIV) on cART from two HIV centres in Lagos state, Nigeria. The EC-clearing house guidelines were employed to categorise oral lesions. Presence or absence of these lesions was reconciled with CD4+ cell count as a measure of efficacy of cART treatment. Results a total of 491 PLWHIV on cART were enrolled, 366 (74.5%) were females and 125 (25.5%) were males. Age ranged between 18-80 years, with a mean of 41.2 ± 9.1 years. On examination, 12 (2.4%) patients presented with HIV oral lesions. Oral hyperpigmentation (10, 2.0%) was the most common lesion seen, followed by oral ulcers (2,0.4%). Majority (75%) of the affected patients were on a Lamivudine containing regimen. 7 out of the 12 patients with oral lesions had CD4+ cell count between 200-500 cell/mm 3 prior to cART initiation. Eleven (92%) of the patients with oral lesions had significant improvement of their CD4+ cell count after cART administration. Conclusion the prevalence of oral lesions in HIV patients on cART therapy in Lagos is low. Oral hyperpigmentation and oral ulcers are the most frequent lesions seen. The presence or absence of oral lesions were not associated with CD4+ cell count. Therefore, we conclude that the oral lesions seen in HIV patients on cART may not be a direct manifestation of the disease.

Associated oral manifestations with HIV southeastern Brazilian patients on antiretroviral therapy

“…Oral lesions are the first indicators of HIV infection and progression to AIDS. Although studies suggested that the introduction of new antiretroviral therapies contributes to the decrease of oral lesions 7 , 11 , 14 , 16 , 20 , 21 , 22 , 23 , 24 , the data of this study verified that the associated oral manifestations with HIV patients remain present even in the HAART era. However, it must be observed that ART therapy (mono, dual, and HAART) contributed to a decrease of oral lesions, independently of therapy.…”

Oral health related quality of life among HIV positive patients attending two HIV outpatient clinics in Nigeria - a cross sectional study

“…The advent of antiretroviral therapy (ART) particularly the highly active antiretroviral therapy (HAART) has improved the quality of life of HIV positive patients and has reduced to a very large extent the prevalence of oral lesions in HIV infected patients 11 , 12 . A lower prevalence of some oral lesions have also been reported in Nigeria 13 . A reduced rate of salivary flow has been reported on PLWHA on HAART which may be related to the type of ART 14 .…”

The Association Between Oral Mucosal Lesions and Oral Health-Related Quality of Life Using the Validated Indonesian Version of OHIP-14 Among People Living with HIV/AIDS

“…This finding aligns with a previous study that also identified oral lesions, including oral hyperpigmentation and aphthous stomatitis in HIV patients on ART. 16 Meanwhile, among HIV patients who were not on ART, observed oral lesions included oral candidiasis, linear gingival erythematous, and oral hairy leukoplakia (OHL). In line with prior research by Batavia et al, the most prevalent oral lesions in people living with HIV and not on ART were acute pseudomembranous candidiasis, oral hairy leukoplakia, and recurrent intraoral herpes.…”