Association between socioeconomic status and HIV-associated oral lesions in Rio de Janeiro from 1997 to 2004

Cesar Werneck Noce,Arley Silva Júnior,Eliane Pedra Dias,Sonia Maria Soares Ferreira

doi:10.1590/s1806-83242009000200010

Cesar Werneck Noce, Arley Silva Júnior + Show 2 more

Open Access

https://doi.org/10.1590/s1806-83242009000200010

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Abstract

The prevalence of HIV-related oral lesions may vary according to socioeconomic status and antiretroviral therapy, among other factors. This study's intent was to evaluate the association between socioeconomic indicators, CD4+ counts and HIV-related oral lesions in the city of Rio de Janeiro, RJ, Brazil. A retrospective epidemiological analysis was performed of the medical records of HIV-positive patients that attended the Federal University of Rio de Janeiro between 1997 and 2004. Gender, age, mode of HIV transmission, level of education, monthly familial income, CD4+ counts and HIV-related oral lesions were assessed. For statistical analysis, the Chi-square test was used with a level of significance of 5%. 254 medical records were reviewed: 83 women and 171 men. Monthly familial income below 2 minimum wages was associated with a higher prevalence of pseudomembranous candidiasis (p = 0.024), while income above 10 minimum wages was associated with a higher prevalence of salivary gland disease (p = 0.021). Lower socioeconomic status was associated with lower CD4+ counts (p = 0.017). In this study, an association was noted between socioeconomic status, immune suppression and prevalence of oral lesions. However, further studies are warranted using other socioeconomic variables in order to better assess this relationship.

Highlights

IntroductionOral lesions are frequent in HIV infection, especially candidiasis, oral hairy leukoplakia, Kaposi’s sarcoma, non-Hodgkin lymphoma and periodontal disease.[1] Some of these lesions, like candidiasis, are important due to their relevance as clinical markers of immune suppression.[2,3,4]
Familial income below 2 minimum wages was associated with a higher prevalence of pseudomembranous candidiasis (p = 0.024), while income above 10 minimum wages was associated with a higher prevalence of salivary gland disease (p = 0.021)
An association was noted between socioeconomic status, immune suppression and prevalence of oral lesions

Summary

Introduction

Oral lesions are frequent in HIV infection, especially candidiasis, oral hairy leukoplakia, Kaposi’s sarcoma, non-Hodgkin lymphoma and periodontal disease.[1] Some of these lesions, like candidiasis, are important due to their relevance as clinical markers of immune suppression.[2,3,4]. The prevalence of oral lesions may be influenced by the social context in which HIV-positive individuals are inserted. Grando et al.[5] (2003) and Challacombe et al.[6] (2002) observed that improved socioeconomic status, as well as adequate medical care and education, exert an important influence on the prevalence of oral lesions. In Brazil, there are 620,000 HIV-positive patients, with an increasing prevalence of HIV/AIDS in individuals with more than 40 years of age, women and with lower levels of education.[7,8]

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