International Journal of Medical Advances and Discoveries

Full Length Research paper

HIV-related oral lesions as markers of immunosuppression in HIV sero-positive Nigerian patients

Olaniyi Olufemi Taiwo¹ and Zuwaira Hassan²

¹Regional Centre for Oral Health Research and Training Initiatives (RCORTI) for Africa, Jos, Nigeria,

²AIDS Prevention Initiatives for Nigeria (APIN) Project, Jos University Teaching Hospital, Jos, Nigeria

Accepted 07 May, 2011

Abstract

This study was carried out to assess the use of HIV-related oral lesions as markers of immunosuppression defined as CD4+ cell counts <200 cells/mm³ and viral load 20,000 copies/ml in HIV positive Nigerian adults. Cross-sectional study on 278 HAART naive adults seen at an AIDS referral Centre.Oral examination was according to the European Community Clearinghouse on oral problems related to HIV infection. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) is reported for oral lesions with plasma HIV-RNA 20,000 copies/ml and CD4 counts <200 cells/mm³. The highest PPV (100%) for CD4 <200 cells/mm³ was noticed from Kaposi’s sarcoma, oral ulcerations and linear gingival erythema, P > 0.05. Lesions with moderate to high PPV for CD4 <200 cells/mm³ were pseudomembraneous candidiasis (96.3%; P = 0.003), angular cheilitis (96.0%; P = 0.004) erythemathous candidiasis (94.4%; P = 0.025), and melanotic hyperpigmentation (87.1%; P = 0.040) . Oral hairy leukoplakia was the only lesion significant for HIV- RNA 20,000 copies/ml (PPV: 89.3%; P < 0.05). Oral candidiasis and melanotic hyperpigmentation could be used as markers of immunosuppression depicted by CD4 counts <200 cells/mm³ while oral hairy leukoplakia could indicate HIV- RNA 20,000 copies/ml in an adult Nigerian population.