Abstract
ObjectiveInvestigation of the prevalence of oral mucosal lesions in human immunodeficiency virus (HIV)‐infected children undergoing highly active antiretroviral therapy (HAART).Materials and MethodsCross‐sectional study of 66 HIV seropositive children, comprised of 28 (42.4%) females and 38 (57.6%) males (average age of 6 years). Study participants all required data regarding CD4+ T‐helper cell counts and the viral load. All participants underwent an orofacial clinical examination by calibrated clinicians. Associations between the presence of oral mucosal lesions, CD4+ cell counts, and viral load were analyzed using Poisson regression.ResultsThe prevalence of oral manifestations was detected in 21 children (31.8%). Oral lesions were detected in 16 children with viral load copies <50 cells/mm3 and 22 children with CD4+ counts >500 cells/mm3. Predominant lesions identified included angular cheilitis (36.7%), candidiasis (13.3%) and atypical oral ulcers (13.3%). The presence of one lesion was the most prevalent represented by 19 children. Oral lesions in relation to the CD4+ counts >500 resulted in; 14 children with one oral lesion, 5 with two lesions and 3 with three oral mucosal lesions. The other half of this CD4+ count patient group presented with no oral mucosal lesions. Oral lesions in relation Viral load copies <50 resulted in; 9 children with one oral lesion, 3 with two oral mucosal lesions and 4 with three oral mucosal lesions. The other half of this Viral load patient group presented with no oral mucosal lesions. No significant correlations were established between the presence of oral mucosal lesions and low CD4+ counts (p = 0.715) nor with high viral load counts (p = 0.638).ConclusionHIV‐related oral mucosal lesions still presented in the participants despite management with HAART. Based on the results, CD4+ counts and viral load does not appear to be suitable markers of orofacial involvement in children.
Highlights
Human immunodeficiency virus (HIV) infections are characterized by suppressed immune systems
Several cardinal oral lesions are associated with the disease progression of HIV/AIDS, including oral candidiasis, hairy leukoplakia, Kaposi sarcoma, linear gingival erythema, necrotizing ulcerative gingivitis, necrotizing ulcerative periodontitis, and non-Hodgkin's lymphoma (NHL) (Coogan, Greenspan, & Challacombe, 2005)
This study aimed to investigate the array of oral mucosal lesions associated with HIV among children living with the disease
Summary
Human immunodeficiency virus (HIV) infections are characterized by suppressed immune systems. The virus targets CD4+ T-helper cells (CD4+ cells) in the immune system, which are meant to assist the body in fighting infections. The 2012 HIV/AIDS prevalence report, concerning South African children between the ages of 0 and 14 years, stated that 1.25 million children were infected out of a population of 52.8 million people (Shisana et al, 2014). In 2017, the same age group represented 3 million infected children out of a total South African population of 57 million people (Simbayi et al, 2018). A South African study recorded an oral lesion prevalence of 51.8% among children between the ages of 0 and 14 years. The study's statistical analysis found no association between age and the prevalence of oral mucosal lesions (Duggal, Abudiak, Dunn, Tong, & Munyombwe, 2010). Oral manifestations of HIV/AIDS are among the earliest signs of the disease and may function as markers of disease progression in both adults and children (Coogan et al, 2005; Miziara & Weber, 2008)
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