HIV disease - Oral lesions and conditions associated with human immunodeficiency virus infection in 300 south Indian patients

BACKGROUND: Human immunodeficiency virus infection/acquired immunodeficienc y syndrome (HIV/AIDS) is a major health problem in India. The National AIDS Control Organisation (NACO) of India reports a seropositivity of 25.03 per thousand for the whole country, as of October 1999, In spite of this high prevalence there are very few reports of oral lesions and conditions in Ind ian HIV/AIDS patients, which are important in early diagnosis and managemen t of these patients. OBJECTIVE AND SETTING: The present report describes the oral lesions in 300 HIV positive symptomatic patients presenting to us at RAGAS-YRG CARE, a no n-governmental organisation in Chennai, South India, over a period of 9 mon ths in 1998. METHOD: Lesions were diagnosed on clinical appearance using international c riteria. RESULTS: Of the 300 patients 89% had acquired the infection through heteros exual contact. There were 205 males and 95 females, aged from 7 months to 7 2 years. Forty-seven percent of the patients were in the age group 21-30 ye ars. CD4 counts were ascertained for 105 patients, 64 (62%) had CD4 counts less than or equal to 200. A total of 217 (72%) of the 300 patients had som e oral lesion when examined. Gingivitis (47%) and pseudomembranous candidia sis (33%) were the most common oral lesions. The other oral lesions seen we re oral mucosal pigmentation (23%), erythematous candidiasis (14%), periodo ntitis (9%), angular cheilitis (8%), oral ulcers (3%), oral hairy leukoplak ia (3%), hyperplastic candidiasis (1%), oral submucous fibrosis (2%) and on e case of leukoplakia. CONCLUSIONS: Oral lesions occur commonly in HIV infection. A comprehensive oral examination may not only suggest HIV disease but may also be useful in monitoring the disease progression. This is a cost-effective procedure, wh ich may be useful in screening large populations in developing countries li ke India.