Oral Cytology for HIV: A New Diagnostic Tool?
OBJECTIVE
To asses morphological and morphometrical alterations of oral squamous epithelial cells in HIV infected individuals, and determine its diagnostic significance for HIV infection.


METHODS
Informed Consent was obtained from all study subjects. 40 adult HIV infected patients (experimental group) and 40 adult non-infected volunteers (control group) participated. Age, occupation, and relevant medical history were recorded. The following laboratory tests reports were recorded: complete blood cell counts, blood glucose levels, serum iron and erythrocyte sedimentation rate. Oral smears were collected from normal appearing tongue and buccal mucosa of the individuals by exfoliative cytology. The cells were morphologically analysed and the nuclear area (NA), the cytoplasmic area (CA) and the nucleus-to-cytoplasm area ratio (NA/CA) were calculated. Cell yield, cell cohesion, presence/absence of inflammatory cells and candida were observed.


RESULTS
The cytological smears of HIV patients showed abundant cell yield and the epithelial cells were found to be in close cohesive clusters and both findings were found to be statistically significant. Nuclear cytoplasmic ratio was seen to be increased in 93.8% of HIV positive patientsand Mild to moderate pleomorphism was observed in 17.9% of HIV positive patients. HIV positive patients had a diminished inflammatory response and this was found to be statistically significant.


CONCLUSIONS
Statistically significant deviations from normal oral epithelium were found in the study conducted. With further research, oral exfoliative cytology may form a new, painless, inexpensive diagnostic method for HIV infections.
Manipal College of Dental Sciences, Mangalore, India.
Vaibhav Mahesh
VM
Jagad
Manipal University, Mangalore, India nandita.shenoy@gmail.com.
Nandita
N
Shenoy
Manipal University, Mangalore, India.
John
J
Ramapuram
Manipal University, Mangalore, India.
Amitha
A
Lewis
Manipal University, Mangalore, India.
N
N
Srikant
Manipal University, Mangalore, India.
Aditi
A
Sarin
D000328:Adult; D016022:Case-Control Studies; D002467:Cell Nucleus / Q000473:pathology; D003584:Cytological Techniques / Q000379:methods*; D003593:Cytoplasm / Q000473:pathology; D004847:Epithelial Cells / Q000473:pathology; D015658:HIV Infections / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D009061:Mouth Mucosa / Q000473:pathology*
HIV; buccal smear; nucleocytoplasmic ratio; oral cytology; retro-positive