Prevalence Of Oral Lesions In Adult Patients Infected By The Human Immunodeficiency Virus And Its Association With Cd4 Counts In Oshakati Hospital, Namibia

ABSTRACT  

In dentistry HIV/AIDS patients with oral lesions are encountered regularly, hence early diagnosis and appropriate treatment is important so as to prolong patient’s life.   The researcher had noticed over time, what appeared to be a significant number of patients with oral lesions who were eligible for highly active antiretroviral therapy treatment, but who were not initiated.  Applicable guidelines were available on how to manage patients with oral lesions as well as recommendations to initiate these patients on highly active antiretroviral therapy, even without the recommended CD4 counts.  There were also no studies in Namibia on the prevalence of HIV/AIDS associated oral and peri-oral lesions and their association with CD4 counts.    It is against this background that this study was conducted to explore and describe the magnitude and prevalence of the different types of oral manifestations of HIV/AIDS and their association with CD4 counts among adult patients attending the Communicable Disease Clinic at the Oshakati Hospital.   A quantitative cross sectional design was used in this study, and 360 patients, representing a 96% participation rate, were included in the study.  Examinations of these patients for oral lesions were done using a checklist based on European Community Clearinghouse criteria. In addition CD4 count results were obtained from patient’s health passports or laboratory results.  It emerged that out of the 360 patients examined, 54.7% had oral lesions, of which 62.9% were females and 37% were males. Cheilitis accounted for the highest number of lesions, namely 20.9%, followed by pseudomembranous candidiasis occurring in  5% of patients.  Herpes simplex lesions were the least seen with only one patient.  Furthermore, a statistical significant association between the development of oral lesions and CD4 counts was found.   In conclusion, the prevalence of HIV associated oral lesions (54.7%) was lower that reported studies of other African countries.   The strong positive association between the occurrence of oral and peri-oral lesions and low CD4 cell counts found in this study could be regarded as an important result in the light of the need for inexpensive surrogate markers of HIV disease progression in resource-poor countries, where the measurement of CD4 cell counts is expensive and in some areas not available.  Recommendations were submitted to the Ministry of Health and Social Services, with the emphasis on health education and involvement of dental personnel in HIV/AIDS programmes.