Relationship between salivary immune markers, cd4+count and hiv-oral lesions among newly diagnosed adults with hiv in southwest Nigeria

Abstract

INTRODUCTION: An understanding of immunological changes in the oral cavity of persons with HIV is pivotal to predicting oral health status in such individuals. This study aimed to assess the correlation between salivary levels of sIgA, cytokines, CD4+ T cell counts, and oral lesions among newly diagnosed adults with HIV before antiretroviral therapy (ART) initiation.
MATERIALS & METHODS: The study was conducted among adults (>18 years) newly diagnosed with HIV who presented at antiretroviral clinics of two tertiary hospitals in Ibadan, Nigeria. Data documented were socio-demographics, oro-facial lesions, CD4+ count, and saliva samples before ART initiation. Saliva assays of sIgA and cytokines were done using ELISA kits. CD4+ counts and saliva analytes were compared between those with and those without oral lesions using the Mann-Whitney U test. SPSS version 25 was used for data analysis.
RESULTS: Seventy one participants were enrolled having 23(32.4%) males and 48(67.6%) females; mean age 38.8±SD 11.7 years. HIV oral lesions seen among the study participants included pseudomembranous and erythematous candidiasis (43.2%), oral melanotic hyperpigmentation (4.5%), and a combination of candidiasis with OMH (11.4%). The mean CD4+ count for all study participants was 356.04 ±244.16 cells/mm3, being lower among those with oral lesions 330.16±282.28 cells/mm3 compared to those without oral lesions 388.29±238.92cells/mm3. Also, the participants had median (inter-quartile range) values of sIgAas 7.99pg/mL (6.14-9.01), IL-6 as 7.09pg/mL (5.93-8.33) and IFN-γ as 6.23pg/mL (5.27-7.60). Comparatively, higher median (IQR) values of IL-10, IL-1β, and TNF-α were found to be 40.38pg/mL (32.61- 45.61), 21.48pg/mL(16.68-26.68) and 20.21pg/mL(14.56-23.82) respectively. Mann-Whitney U test revealed higher mean rank values for sIgA, IL-1β, IL-6, and IFN-γ, but IL-10 was lower among participants with oral lesions. Only TNF-α did not vary with the presence or absence of oral lesions.
CONCLUSION: HIV- oral lesions were found to be associated with lowered CD4+ count as well as salivary cytokine dysregulation.