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Relationship between CD4⁺ count, serum inflammatory cytokines, and oral melanotic hyperpigmentation in newly

Elizabeth Oluwatoyin Abe¹, Akinyele Olumuyiwa Adisa¹, Bukola Folasade Adeyemi¹

¹Department of Oral Pathology/Oral Medicine, University College Hospital, Ibadan, Nigeria.

Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology

|December 3, 2021

Abstract

Objective:

Oral melanotic hyperpigmentation (OMH) in patients with human immunodeficiency virus (HIV) infection has been attributed to the use of antifungal or antiretroviral drugs, as well as HIV-induced cytokine dysregulation. This research aimed to determine the relationship between immunosuppression and cytokine dysregulation in newly diagnosed HIV-seropositive subjects with OMH.

Study Design:

The study was conducted among newly diagnosed HIV-seropositive patients at the Infectious Disease Clinic, Ibadan, Nigeria. The cases were patients with OMH matched for age and sex with control subjects without OMH. CD4⁺ count and cytokine levels (interleukin-6 and tumor necrosis factor-α) were compared between the cases and control subjects. SPSS version 21 software was used for data analysis.

Results:

Seventy newly diagnosed HIV-seropositive patients were studied, which comprised of 35 cases and 35 control subjects. The median CD4⁺ counts for cases and control subjects were 174 cells/mm³ (interquartile range [IQR], 57-250) and 324 cells/mm³ (IQR, 107-424), respectively. Severe immunosuppression (CD4⁺ count, ≤200 cells/mm³) was found in over half of the study participants, being more prevalent among the cases than among the control group (P = .019). Serum cytokine levels did not significantly vary between the cases and control subjects.

Conclusions:

There was a significant association between HIV-OMH and severe immunosuppression in the newly diagnosed HIV-seropositive patients.

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