Oral Candidiasis: A Tool For The Detection Of Presence And Progression Of Hiv Infection In Children In Maiduguri, Nigeria

Abstract

Oral cavity is an important and frequently undervalued source of diagnostic and prognostic information in patients with Human Immunodeficiency virus (HIV) infection. This objectives of the study were to determine the prevalence of HIV infection in children using oral thrush as a marker of disease presence and to find out the relationship of CD4 count with oral candidiasis in HIV-infected children. The study group consisted of 108 children aged 18 months to 5 years presenting with oral thrush as seen in the paediatric units of the University of Maiduguri Teaching Hospital (UMTH), Maiduguri, Nigeria from July 2006 to June 2007. The diagnosis of HIV infection was made by double ELIZA technique and Dynal beads technique (Dynal Biotech, Oslo, Norway) for CD4 counting was used. Of the 108 children, 60 (55.5%) male and 48 (44.5%) were female with a male to female ratio of 1.25:1. Twenty children (18.5%) were found to be HIV sero-positive by double ELISA technique. Fifteen (75%) of positive children were less than 36 months, with 18 (90%) of the positive children coming from the lower socio-economic classes 4 and 5. Mother to child transmission (MTCT) was found to be responsible for 85% of infection in the present study (P<0.000). Fifteen (75%) had CD4+ count less than 500 cells/µl, with the mean and median counts of 433.1 cells/µl (±261 cells/µl) and 354cells/µl respectively. The results of our study emphasise the usefulness of oral cavity as an important source of diagnostic and prognostic information in HIV-infected children and recommend the use of oral candidiasis as an adjunct clinical marker of HIV disease presence and progression.

Keywords: Oral thrush, adjunct marker, HIV

Annals of Biomedical Sciences Vol. 6 (2) 2007: pp. 28-35