Oral Manifestations of HIV–AIDS in Yunnan Province of China

Objectives: To investigate the oral lesions present in HIV infected individuals in Yunnan Province of China and to investigate associations between immune status and oral manifestations (OMs).

Methods: HIV-infected patients not receiving highly active antiretroviral therapy (HAART) were selected. Two dentists examined the study group over an 18 month period and recorded the CD4 lymphocyte count. The oral lesions were diagnosed on clinical appearance using internationally agreed criteria.

Results: A total of 268 patients matched the selected criteria. They were composed of 181 (67%) male and 87 (33%) females. Median age of the group was 41years (range 21 to 74). 239 were Han (89%). 29(11%) were other ethnicities (Yi, Bai, Dai, Hani, Tibetan). 81 individuals were unemployed and 50% had a history of using intravenous recreational drugs. Oral lesions were observed in 71%. These oral lesions included: pseudomembranous (16.8 %) and erythematous (27%) candidosis, angular cheilitis (8%), oral ulceration (13.9 %), oral hairy leukoplakia (OHL) (3%), herpetic stomatitis (7.6%). Hairy leukoplakia and oral candidosis were inversely correlated to CD4+ count.

Conclusion: OHL and candidosis associated with HIV infection may be useful markers of disease progression in this population. Oral candidosis is the most common opportunistic infection. Well-designed longitudinal studies are necessary for the correct assessment of role of oral lesions as surrogate markers of HIV infection in China.