Oral manifestation of HIV/AIDS infections in paediatric Nigerian patients

Abstract

Background: The aims of this study were to determine the pattern and frequency of oral lesions and to compare the prevalence of HIV‑related oral lesions in paediatric Nigerian patients on HAART with those not on HAART. Materials and Methods: All patients aged 15 years and below attending the Infectious Disease Clinic of Aminu Kano Teaching Hospital with a diagnosis of HIV were consecutively examined in a cross‑sectional study over a 2‑year period. Information was obtained by history, physical examinations, HIV testing, and enumeration of CD+ T cells. The results are presented. A P‑value of <0.05 was considered significant. Results: A total of 105 children comprising 63 males and 42 female who met the inclusion criteria participated in the study, mean age in months was 53.3±42.2, with a mean of 3.4±2.2 for male and 2.8±1.8 for female respectively. Oral lesions occurred in 61.9% of the children Overall, 22 (21.0%) had at least one oral lesion, 43 (41.0%) had multiple lesion. The most common lesion was oral candidiasis (79.1%). The angular cheilitis (43.8%) variant was most frequent. The mean CD4 counts were 1138 cells/mm3, 913 cells/mm3 and 629 cells/mm3 for those without oral lesion, with single lesion and multiple oral lesions respectively. These differences were not statistically significant (ANOVA: F=0.185, df=2, 80, 82, P=0.831. Patients on HAART comprised about 61.9% and these were found to have reduced risk for development of such oral lesions as angular cheilitis (OR=0.76; 95% CI=0.56‑1.02; P=0.03), pseudomembranous candidiasis (OR=0.71; 95% CI=0.54‑0.94; P=0.024) and HIV‑gingivitis (OR=0.59; 95% CI=0.46‑0.75; P=0.001). HAART had some beneficial but insignificant effect on development of HIV‑periodonttitis (OR=0.60; 95% CI=0.51‑0.70; P=0.09). The chances of occurrence of other oral lesions were not significantly reduced by HAART (Kaposi sarcoma, OR=1.24; 95% CI=0.31‑5.01; P=0.47, erythematous candidiasis, OR=1.13; 95% CI=0.62‑2.06). Conclusion: HIV‑related Oral lesions are frequently seen in HIV‑infected Nigerian children. Paediatric patients receiving HAART had significantly lower prevalence of oral lesions, particularly oral candidiasis and HIV‑gingivitis.

Keywords: HIV/AIDS, Nigeria, oral manifestations, paediatrics

Nigerian Medical Journal | Vol. 53 | Issue 3 | July-September | 2012