Oral lesions and their association with CD4 count and viral load in HIV positive Nigerian children.

Background: ral lesions may indicate the presence of HIV infection and may differ in children and adults in different regions.

Aim: To determine the prevalence, types of oral lesions in HIV positive children and their association with the clinical stage, CD4 count and viral load.

Methods: A cross-sectional study involving consecutive HIV positive children whose sero-positive status was confirmed with ELISA screening and Western immunoblot. Oral lesions were diagnosed clinically by a trained dental surgeon using previously established classification. Data obtained was analyzed with SPSS 15.0.

Results: There were 127 children with age range of 3 to 204 months (median: 60 months) and male preponderance of 58.3% (n=74). 55.9% (n=71) of the subjects had oral lesions and pseudomembranous candidiasis (55.9%) was the commonest followed by caries (12.7%), xerostomia (7.8%) and gingivitis (6.9%). Correlation between prevalence of oral lesions and clinical stage of the disease did not reveal any statistically significant association (p=0.354). Also there is no statistically significant difference in prevalence of oral lesions between children on Antiretroviral Therapy (ART) and those who are not on ART (p=0.875). Incidence of oral lesions was however associated with lower mean baseline CD4 count (p= 0.004) but not with mean log10 viral load (p=0.256).

Conclusion: This study has shown that HIV associated oral lesions are prevalent in our environment and antiretroviral therapy does not have significant correlation with occurrence of these lesions in HIV infected children. CD4 count is a better indicator of disease progression than viral load.