Necrotising ulcerative gingivitis/periodontitis as indicators of HIV-infection.
Necrotising ulcerative gingivitis/periodontitis (NUG/NUP) are well-documented oral manifestations of HIV infection/AIDS. However, no information is available regarding the predictive value of NUG in the diagnosis of HIV-infection in South Africa.


OBJECTIVE
The purpose of this study was to determine a possible correlation between NUG/NUP and HIV infection in the as yet undiagnosed patients.


METHODS
Eighty-six systemically asymptomatic patients were diagnosed with NUG/NUP. All patients were treated with 400 mg of metronidazole and 500 mg paracetamol, three times a day for five days. Mechanical debridement under local anesthesia was performed five days after the initial consultation. The possible involvement of HIV-infection was explained and patients were advised to have a blood test taken.


RESULTS
Fifty-six patients consented and received pre- and post-test counselling. Of the fifty-six patients, thirty-nine were found to be HIV positive with CD+ T cell counts ranging between 9 and 1,205 cells/mm3. There was a statistically significant correlation between CD4+ T cells below 500 cells/mm3 (p = 0.000) as well as with CD4+ T cells below 200 cells/mm3 (p = 0.001) and NUP/NUG.


CONCLUSIONS
From these results it is concluded that in the GaRankuwa and surrounding areas, NUG/NUP in otherwise systemically healthy individuals is strongly correlated with HIV infection, with a predictive value of 69.6 per cent (p = 0.01). It is recommended that patients presenting with these conditions be encouraged to undergo testing to establish their HIV status for appropriate referrals and management.
Shangase
L
L
Dept of Periodontology and Oral Medicine, Faculty of Dentistry, Medunsa.
Feller
L
L
Blignaut
E
E
D000082:Acetaminophen / Q000627:therapeutic use; D000293:Adolescent; D000328:Adult; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000627:therapeutic use; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count; D002648:Child; D002675:Child, Preschool; D002710:Chlorhexidine / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D005260:Female; D005892:Gingivitis, Necrotizing Ulcerative / Q000150:complications*; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use; D008875:Middle Aged; D010518:Periodontitis / Q000150:complications*; D011237:Predictive Value of Tests; D013019:South Africa
D018712:Analgesics, Non-Narcotic; D000890:Anti-Infective Agents; D000891:Anti-Infective Agents, Local; D008795:Metronidazole; D000082:Acetaminophen; D002710:Chlorhexidine