Oral cytology in human immunodeficiency virus (HIV): An immune marker? (original) (raw)
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Journal of International Oral Health : JIOH, 2015
Background: The aim of this study was to evaluate the clinical lesions of human immunodeficiency virus (HIV)/acquired immune deficiency syndrome patients in the oral cavity, head and neck region and to determine their associations with level of immune suppression as measured by the CD4+ count. Materials and Methods: In a descriptive cross-sectional study, 50 patients with a proven HIV infection were evaluated. Based on the clinical findings and CD4+ counts, the relationships between oral lesions and CD4+ cell count were investigated. Results: The CD4+ count (cells/mm3) was <200, 200-500, and >500 in 32 cases (64%), 16 cases (32%) and 2 cases (4%) respectively, and the mean CD4+ count was 169.82 cells/mm3 in males and 142.8 cells/mm3 in females. All patients showed at least one oral manifestation. The most common oral lesion identified was pseudomembranous candidiasis accounting for 76% (38/50) followed by periodontal disease 34% (17/50), herpetic lesions and hairy leukoplakia ...
Annals of medical and health sciences research, 2014
Oral lesions are common findings in human immunodeficiency virus (HIV) infection. The main factor associated with the development of oral lesions is damage to the immune system, specifically loss of CD4+ lymphocytes, which are involved in cell-mediated immunity. This study was aimed to determine the association of oral lesions in HIV/acquired immune deficiency syndrome women patients with the level of immune suppression as measured by the CD4+ counts. This was a prospective cross-sectional study with a study population of 191 consecutive female patients seen at the University of Benin Teaching Hospital, Nigeria. Ethical clearance was obtained from the institution of study and informed consent was given by every participant. HIV sero-status was determined for all patients. CD4+ count was analyzed for both the HIV+ and HIV- women with oral lesions. The relationships between oral lesions and CD4+ cell count were investigated. About 56.0% (107/191) of the 191 women studied were HIV posi...
The Aim of this study was to investigate the correlation of oral lesions in HIV positive patients with their CD4, CD8 cell count and CD4/CD8 ratio. 150 HIV seropositive patients of any age and sex were evaluated. Then analyses of data obtained were revealed Pseudo membranous candidiasis (P-0.0043) was the most common variant, mostly seen when CD8 count was increased (>500 cells/mm 3 , P-0.05) and CD4/CD8 ratio was > 0.31(P-0.0034). Periodontal diseases (29%) mostly were seen in patients with CD4 count >400 cell/ mm 3 (P-0.045), CD8 count >500 CD8 cell/mm 3 (P-0.55) and CD4/CD8 ratio < 0.3(P-0.28). Oral lesions were seen when CD8 count is increased >500 cells/mm 3 and CD4/CD8 ratio is in between 0.31 -0.6. Oral lesions especially oral candidiasis can be useful as a diagnostic marker for immunosuppression in HIV positive patients, particularly where laboratory assessment cannot be done routinely.
Oral Cytology for HIV A New Diagnostic Tool?
To asses morphological and morphometrical alterations of oral squamous epithelial cells in HIV infected individuals, and determine its diagnostic significance for HIV infection. Materials and Methods: Informed Consent was obtained from all study subjects. 40 adult HIV infected patients (experimental group) and 40 adult non-infected volunteers (control group) participated. Age, occupation, and relevant medical history were recorded. The following laboratory tests reports were recorded: complete blood cell counts, blood glucose levels, serum iron and erythrocyte sedimentation rate. Oral smears were collected from normal appearing tongue and buccal mucosa of the individuals by exfoliative cytology. The cells were morphologically analysed and the nuclear area (NA), the cytoplasmic area (CA) and the nucleus-to-cytoplasm area ratio (NA/ CA) were calculated. Cell yield, cell cohesion, presence/absence of inflammatory cells and candida were observed. Results: The cytological smears of HIV patients showed abundant cell yield and the epithelial cells were found to be in close cohesive clusters and both findings were found to be statistically significant. Nuclear cytoplasmic ratio was seen to be increased in 93.8% of HIV positive patientsand Mild to moderate pleomorphism was observed in 17.9% of HIV positive patients. HIV positive patients had a diminished inflammatory response and this was found to be statistically significant. Conclusion: Statistically significant deviations from normal oral epithelium were found in the study conducted. With further research, oral exfoliative cytology may form a new, painless, inexpensive diagnostic method for HIV infections.
Contemporary Clinical Dentistry, 2016
Background: The human immunodeficiency virus (HIV) infection which manifests as acquired immunodeficiency syndrome (AIDS) is a disease involving the defects of the T-lymphocyte arm of the immune system. Certain laboratory parameters such as the cluster of differentiation (CD4) count and clinical parameters have long been used as markers of disease progression. In industrialized countries, many studies show a highly correlation between the incidence of oral lesions and immunosuppression and hence, can be used as a marker of immunosuppression. This might not be applicable to a developing country like India. In this study, efforts have been made to supplement the present knowledge on various aspects of oral manifestations in HIV patients in the Indian subcontinent. Aims: To correlate the oral manifestations in HIV/AIDS patients to the level of circulating CD4+ T-lymphocyte count and their effect in anti-retroviral therapy (ART). Subjects and Methods: A total of 104 HIV positive patients were examined for oral lesions. The CD4 count estimated on the same day by fluorescent activated cell sort count machine was then correlated with various oral lesions. Results: Oral manifestations appeared when CD4 count decreased below 500 cells/mm 3. Moreover, oral lesions found at different stages showed very strong correlation to their respective CD4 count. Furthermore, there was considerable decline in the incidence of oral manifestations in patients undergoing highly active ART. Conclusions: Oral manifestations are highly predictive markers of severe immune deterioration and disease progression in HIV patients.
Oral manifestations and their correlation to baseline CD4 count of HIV/AIDS patients in Ghana
Journal of the Korean Association of Oral and Maxillofacial Surgeons, 2017
Acquired immunodeficiency syndrome (AIDS) is a disease of the human immune system caused by the human immunodeficiency virus (HIV). People with AIDS are much more vulnerable to infections, including opportunistic infections and tumors, than people with a healthy immune system. The objective of this study was to correlate oral lesions associated with HIV/AIDS and immunosuppression levels by measuring clusters of differentiation 4 (CD4) cell counts among patients living in the middle western regions of Ghana. A total of 120 patients who visited the HIV clinic at the Komfo Anokye Teaching Hospital and the Regional Hospital Sunyani of Ghana were consecutively enrolled in this prospective and cross-sectional study. Referred patients' baseline CD4 counts were obtained from medical records and each patient received an initial physician assessment. Intraoral diagnoses were based on the classification and diagnostic criteria of the EEC Clearinghouse, 1993. After the initial assessment, e...
Medicina oral, patologia oral y cirugia bucal, 2006
AIM To determine the prevalence of oral lesions in a HIV+ group of patients, related to CD4 cell count and viral load in a Venezuelan population. MATERIALS AND METHODS In the present study, we evaluated 75 HIV+ adult patients, attended at the Center of Infectious Diseases, at the Faculty of Dentistry, Central University of Venezuela. Each patient was clinically examined for detection of oral mucosal lesions. In addition, CD4 cell count was determined by flow cytometry, as well as viral load by RT-PCR (Amplicor HIV-RNA, TM test 1.5, Roche). RESULTS 85% (64/75) of HIV/AIDS patients showed associated HIV lesions. Oral Candidiasis constituted the most common lesion representing a 61% (39/64), followed by Oral Hairy Leukoplakia 53% (34/64); Oral Leukoplakia 34% (22/64), Melanic Hyperpigmentation 38% (18/64); Papilloma 13 (6/64), Lineal Gingival Erythema 8% (5/64); Aphtous Recurrent Stomatitis 5% (4/64) and Kaposi's Sarcoma 5% (3/64). Only one case of the following lesions were repres...
Relationship of Oral Lesions and CD4 Count in Female HIV Patients in South Western Nigeria
British Journal of Medicine and Medical Research, 2015
Background: Oral lesions have been reported to be early clinical features of HIV infection. Objective: The purpose of this study was to establish the prevalence of oral lesions in HIV Seropositive female patients and correlate the CD4 count with the appearance of oral lesions in the female patients attending Lagos University Teaching Hospital (LUTH) and University of Benin Teaching Hospital, Benin (UBTH). Methods: A prospective study was undertaken in 172 newly diagnosed adult HIV infected female patients (not on antiretroviral therapy), who attended the PEPFAR clinic at LUTH and the HIV Clinic of the University of Benin Teaching Hospital, Benin City, Nigeria. They were assessed for oral lesions which were evaluated using EEC/WHO (2003) -Classification on the diagnostic criteria for oral lesions in HIV. Data were collected using an interviewer administered questionnaire. Following Oral examination undertaken, oral lesions were detected, recorded and
Introduction: Human immunodeficiency virus (HIV) infection gradually destroys the body's immune system, which makes it harder for the body to fight infections. HIV infection causes a quantitative and qualitative depletion of CD4 lymphocyte count, which increases the risk of opportunistic infections. Thus, CD4 count is one of the key factors in determining both the urgency of highly active antiretroviral therapy (HAART) initiation and the need of prophylaxis for opportunistic infections. Aim: This study aims to evaluate the prevalence and variations in the oral manifestations of HIV/acquired immune deficiency syndrome patients on HAART therapy in urban population and their association with CD4 count. Materials and Methods: A study was conducted by screening eighty patients who were HIV positive in an urban location. Both adult and pediatric patients were screened for oral manifestations and simultaneously CD4 count was also evaluated. Patients with HIV infection for variable time period who are under HAART were considered. Statistical Analysis: Measures of central tendency were used to analyse the data. Results: HIV infection destroys the immune system of an individual, making the patient susceptible to various infections and malignancies. With the advent of antiretroviral therapy, the scenario has changed drastically. We have observed that patients with CD4 counts between 164 and 1286 show relatively few oral manifestations. Long-term HAART therapy causes pigmentation, xerostomia and angular cheilitis but is taken up quite well by the patients. Conclusion: In this study, eighty patients with HAART from urban population showed very minimal oral findings because of good accessibility for treatment and awareness about HIV infections. The patients who were on long-standing HAART treatment also showed minimal oral manifestation such as pigmentation and xerostomia. Hence, we conclude that recognition, significance and treatment of these lesions in patients with HIV infection do not require elaborate setup and can be treated with basic primary health care.