title: Oral manifestations and their correlation to baseline CD4 count of HIV/AIDS patients in Ghana.
abstract: OBJECTIVE
  Acquired immunodeficiency syndrome (AIDS) is a disease of the human immune system caused by the human immunodeficiency virus (HIV). People with AIDS are much more vulnerable to infections, including opportunistic infections and tumors, than people with a healthy immune system. The objective of this study was to correlate oral lesions associated with HIV/AIDS and immunosuppression levels by measuring clusters of differentiation 4 (CD4) cell counts among patients living in the middle western regions of Ghana.
  
  
  METHODS
  A total of 120 patients who visited the HIV clinic at the Komfo Anokye Teaching Hospital and the Regional Hospital Sunyani of Ghana were consecutively enrolled in this prospective and cross-sectional study. Referred patients' baseline CD4 counts were obtained from medical records and each patient received an initial physician assessment. Intraoral diagnoses were based on the classification and diagnostic criteria of the EEC Clearinghouse, 1993. After the initial assessment, extra- and intraoral tissues from each enrolled patient were examined. Data analyses were carried out using simple proportions, frequencies and chi-square tests of significance.
  
  
  RESULTS
  Our study included 120 patients, and was comprised of 42 (35.0%) males and 78 (65.0%) females, ranging in age from 21 to 67 years with sex-specific mean ages of 39.31 years (males) and 39.28 years (females). Patient CD4 count values ranged from 3 to 985 cells/mL with a mean baseline CD4 count of 291.29 cells/mL for males and 325.92 cells/mL for females. The mean baseline CD4 count for the entire sample was 313.80 cells/mL. Of the 120 patients we examined, 99 (82.5%) were observed to have at least one HIV-associated intraoral lesion while 21 (17.5%) had no intraoral lesions. Oral candidiasis, periodontitis, melanotic hyperpigmentation, gingivitis and xerostomia were the most common oral lesions.
  
  
  CONCLUSIONS
  From a total of nine oral lesions, six lesions that included oral candidiasis, periodontitis, melanotic hyperpigmentation, gingivitis, xerostomia and oral hairy leukoplakia were significantly correlated with declining CD4 counts.
authors.affiliation: Oral and Maxillofacial Microvascular Reconstruction LAB, Brong Ahafo Regional Hospital, Sunyani, Ghana.
authors.forename: Paul
authors.identifier: 0000-0002-1647-2155
authors.initials: P
authors.lastname: Frimpong
authors.affiliation: Oral and Maxillofacial Microvascular Reconstruction LAB, Brong Ahafo Regional Hospital, Sunyani, Ghana.
authors.forename: Emmanuel Kofi
authors.identifier: 0000-0002-0720-3025
authors.initials: EK
authors.lastname: Amponsah
authors.affiliation: Department of Ear, Nose and Throat, Brong Ahafo Regional Hospital, Sunyani, Ghana.
authors.forename: Jacob
authors.identifier: 0000-0003-1125-5482
authors.initials: J
authors.lastname: Abebrese
authors.affiliation: Oral and Maxillofacial Microvascular Reconstruction LAB, Brong Ahafo Regional Hospital, Sunyani, Ghana.; Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea.
authors.forename: Soung Min
authors.identifier: 0000-0002-6916-0489
authors.initials: SM
authors.lastname: Kim
keywords: Acquired immune deficiency syndrome; Cluster of differentiation 4 (CD4) cells; HIV; Oral manifestations