Abstract
Low CD4 counts is currently considered to be one of the main indicators of the progression of human immunodeficiency virus (HIV)-induced immune depression, but few studies have analyzed its relationship to the presence of oral cytological changes. The aim of this cross sectional study was to analyze the relationship between total CD4 lymphocyte count and the occurrence of cytological changes. The present cross-sectional study included 40 HIV infected patients seen at a clinic for sexually transmitted diseases and HIV. Oral smears were obtained from dorsum of the tongue and the buccal mucosa using tongue blade and smear was transferred on a glass slide and fixed. The samples were assessed for the presence or absence of cytological changes, and correlated it with their CD4 counts. The CD4 lymphocyte counts of each of the 40 cases was noted and categorized as those below 500 cells/mm3 and above 500 cells/mm3. A total of 24 cases showed CD4 counts less than 500 cells. It was observed that the lesser the CD4 lymphocyte count, the greater the cell yield. These findings suggest that oral cytological changes could be a useful clinical marker of patients with HIV and can also be used as an adjuvant to CD4 counts. In view of these results, emphasis should be placed on the importance of thorough examination of the oral cavity and obtaining oral smears, as these changes provides indirect information about the patient’s immune state. Key words: Human immunodeficiency virus (HIV) infection, oral cytology, CD4 counts.
Highlights
Human immunodeficiency virus (HIV) infection is characterized by progressive and continuous impairment of the immune system function, with varying rate of progression among patients
All patients had been diagnosed with HIV infection by enzyme-linked immunosorbent assay (ELISA), and the diagnosis was confirmed by Western blot analysis
The patients seen at this clinic were first evaluated by physicians who specialized in HIV infection; these physicians determined from the patient’s medical history if they met the criteria for inclusion in the study
Summary
Human immunodeficiency virus (HIV) infection is characterized by progressive and continuous impairment of the immune system function, with varying rate of progression among patients. Antiretroviral treatments (HAART) have been shown to be effective in arresting immune system impairment and prevention of disease progression. The CD4 T-lymphocyte (CD4) count is considered the best laboratory marker of progression of HIV disease (Fahey et al, 1990). Many HIV-associated oral disorders occur early in HIV infection, not infrequently. Early detection of associated oral disease should, in many cases, result in earlier diagnosis of HIV infection (Ranganathan et al, 2000). HIV affects primarily the immune cells but there are studies (Montaner et al., 1992) which have concentrated on the cervical and gastrointestinal epithelium when investigating the various mechanisms of HIV infection across mucosal surfaces. Informed consent was obtained from all study subjects before obtaining oral smears
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