Occurrence of oral lesions in relation to clinical and immunological status among HIV-infected adult Tanzanians.
OBJECTIVE
To determine the association, if any, between the presence of oral lesions and clinical and immunological status of untreated HIV-infected adults in Tanzania.


METHODS
A cross-sectional study.


METHODS
AIDS Clinical Trial Clinic (ATCC) at Muhimbili Medical Centre in Dar-es-Salaam, Tanzania.


METHODS
192 HIV-infected individuals not receiving treatment; 156 individuals confirmed to be HIV-seronegative acted as a control group.


METHODS
Examination of oral structures, determination of HIV serostatus, clinical status, and peripheral CD4+ T cell and total lymphocyte counts.


METHODS
Presence of oral lesions.


RESULTS
Intra-oral lesions were seen among 7.7% of the HIV-seronegative, 10.4% of the HIV-seropositive and 36.8% of the AIDS groups, respectively. Enlarged parotid glands were seen in 20% of the AIDS patients, 11.9% of the HIV-seropositives, and 5.1% of the HIV seronegatives. Enlargement of submandibular salivary glands was seen in 29.6% of the AIDS patients, 31.3% of the HIV-seropositives compared with 14.7% among the HIV-seronegatives. Multiple regression analysis was used to calculate adjusted odds ratio (OR) for presence of oral lesions. OR for an intra-oral lesion was 1.6 (95% CI = 0.5; 5.0) among the HIV-seropositives and 8.2 (95% CI = 3.5; 19.7) among the AIDS patients using the HIV-seronegatives as reference. OR for an intra-oral lesion was 0.9 (95% CI = 0.3; 2.9) in HIV-infected patients with peripheral CD4+ T cell count of between 200-500 cells mm-3 and 2.7 (95% CI = 0.9; 7.7) in patients with less than 200 cells mm-3. OR for an intra-oral lesion was 0.4 (95% CI = 0.2; 0.9) for patients with peripheral total lymphocyte counts of between 1000-2000 cells mm-3 and 0.9 (95 CI = 0.4; 2.0) for patients with less than 1000 cells mm-3.


CONCLUSIONS
The association of oral lesions with the clinical stage of HIV infection and to a lesser extent peripheral CD4+ T cell count does suggest that these lesions could be used as additional markers of immunosuppression and AIDS.
Matee
M I
MI
Department of Microbiology and Immunology, Muhimbili University College of Health Sciences, PO Box 65001, Dar es Salaam, Tanzania. hdmim@muchs.ac.tz
Scheutz
F
F
Moshy
J
J
D017088:AIDS-Related Opportunistic Infections / Q000209:etiology*; D000163:Acquired Immunodeficiency Syndrome / Q000097:blood / Q000150:complications / Q000276:immunology; D000328:Adult; D018791:CD4 Lymphocyte Count; D016009:Chi-Square Distribution; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000150:complications* / Q000276:immunology; D018023:HIV Seronegativity; D006801:Humans; D018655:Lymphocyte Count; D008297:Male; D009059:Mouth Diseases / Q000209:etiology*; D016017:Odds Ratio; D010305:Parotid Diseases / Q000209:etiology; D012044:Regression Analysis; D013364:Submandibular Gland Diseases / Q000209:etiology; D013636:Tanzania