Oral Lesions in HIV Infection in Developing/Resource Poor Countries

The major global burden of HIV infection is in the developing countries. Oral lesions, in addition to being an indicator of the degree of immunosupression, play an important role in the diagnosis of HIV infection. This presentation will compare the oral lesions reported from the developing countries between 2004 and 2008 and elaborate on the oral lesions seen in a cohort of 3406 cases at Ragas Dental College and Hospital, Chennai, South India. Among the 3406 patients studied, male to female ratio was 2.6:1 and 90.4% of patients had acquired the infection via heterosexual contact. Majority of patients (79.3%) were in the 21 – 40 year age group. Pulmonary tuberculosis (9.4%) was the most common systemic finding. Oral lesions were seen in 79.5% of the patients studied. Gingivitis (72.2%) and oral melanin pigmentation (20.9%) were the most common lesions, followed by oral candidiasis (17.3%), periodontitis (17.2%), angular cheilitis (5.5%), oral ulcers (3.2%), leukoplakia (1.1. %), oral hairy leukoplakia (1.0%), oral submucous fibrosis (0.6%) and Herpes labialis (0.2%). Oral candidiasis, periodontitis, gingivitis, and oral hairy leukoplakia were more in males than in females.

A comparison of the overall prevalence of oral lesions in patients on HAART and not on HAART revealed that 80.9% of the former and 79.2% of the latter had oral lesions; this difference was not statistically significant. Patients not on HAART showed a greater prevalence of oral candidiasis, oral hairy leukoplakia, actinic cheilitis, ulcerations, and periodontitis. Pigmentation was more prevalent in the HAART group.

These features will be compared with the data from Ethiopia, Brazil, Nigeria, Venezuela and other developing countries, and their significance will be discussed.