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Oral mucosal lesions and immune status in HIV-infected Indian children
Priya Subramaniam1, Krishna Kumar
1The Oxford Dental College and Hospital, Pedodontics and Preventive Dentistry, Bangalore, India.
Insights
Oral mucosal lesions are common in Indian children with human immunodeficiency virus (HIV). Lower CD4 cell counts correlate with a higher frequency of these lesions, highlighting the link between immune status and oral health in pediatric HIV.
Area of Science:
- Oral Medicine
- Pediatric Infectious Diseases
- Immunology
Background:
- Pediatric human immunodeficiency virus (HIV) infection is a growing concern in developing nations.
- Children with HIV are susceptible to opportunistic infections, with oral manifestations often being the initial clinical sign.
- Assessing oral mucosal status is crucial for monitoring disease progression and immune status in pediatric HIV patients.
Purpose of the Study:
- To evaluate the oral mucosal status of Indian children diagnosed with HIV.
- To investigate the correlation between CD4 cell counts and the presence/frequency of oral lesions in pediatric HIV patients.
Main Methods:
- A cohort of 221 HIV-infected children (aged 6-18 years) was divided into three groups based on CD4 cell counts (≥500, 201-499, ≤200 cells/µL).
- Children were categorized as 'prior to antiretroviral treatment (ART)' or 'on ART'.
- Oral mucosal examinations were performed using presumptive criteria for HIV-associated oro-facial lesions, followed by statistical analysis.
Main Results:
- Angular cheilitis and pseudomembranous candidiasis were the most prevalent oral lesions observed.
- A statistically significant inverse relationship was found between CD4 cell count and the frequency of oral lesions.
- Children with higher CD4 cell counts (≥500 cells/µL) exhibited significantly fewer oral lesions.
Conclusions:
- A substantial proportion of HIV-infected children present with oral mucosal lesions.
- Immune status, as indicated by CD4 cell counts, is significantly associated with the frequency and type of oral lesions in pediatric HIV.
- Regular oral examinations are vital for early detection and management of oral complications in children living with HIV.
Objective:
Pediatric HIV is growing at an alarming rate in developing countries. Due to their compromised immune status, children infected with HIV are prone to a number of opportunistic infections. Oral manifestations are the first signs of the disease in many of them. To assess the oral mucosal status of Indian children with HIV, based on their CD4 cell counts.
Methodology:
Two hundred and twenty one HIV infected children aged 6-18 years from various HIV centers, were divided into three groups, based on their CD4 cell counts; Group 1: ≥500, Group 2: 201-499 and Group 3: ≤200 cells. The children in each group were further considered as 'prior to antiretroviral treatment (ART)' and 'on ART'. Oral mucosal examination was done based on presumptive criteria given by Ramos-Gomez for diagnosis of oro-facial lesions commonly associated with HIV infection in children. Data obtained was subjected to statistical analysis.
Results:
Angular cheilitis and pseudomembranous candidiasis were the frequently seen oral lesions. Children with CD4 cell count ≥500 had significantly fewer oral lesions each.
Conclusion:
A high percentage of HIV-infected children were affected with oral mucosal lesions. There was a significant association between immune status and frequency of oral lesions.
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