J Korean Assoc Oral Maxillofac Surg 2017; 43(1): 29~36
Oral manifestations and their correlation to baseline CD4 count of HIV/AIDS patients in Ghana
Paul Frimpong1, Emmanuel Kofi Amponsah1, Jacob Abebrese2, Soung Min Kim1,3
1Oral and Maxillofacial Microvascular Reconstruction LAB, 2Department of Ear, Nose and Throat, Brong Ahafo Regional Hospital, Sunyani, Ghana, 3Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
Soung Min Kim
Oral and Maxillofacial Microvascular Reconstruction LAB, Ghana Health Service, Regional Hospital, P.O. Box 27, Sunyani, Brong Ahafo, Ghana
TEL: +233-249-681-906   E-mail: smin5@snu.ac.kr
ORCID: http://orcid.org/0000-0002-6916-0489
Received April 23, 2016; Revised June 30, 2016; Accepted July 22, 2016.; Published online February 28, 2017.
© Korean Association of Oral and Maxillofacial Surgeons. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Objectives: Acquired immunodeficiency syndrome (AIDS) is a disease of the human immune system caused by the human immunodeficiency virus (HIV). People with AIDS are much more vulnerable to infections, including opportunistic infections and tumors, than people with a healthy immune system. The objective of this study was to correlate oral lesions associated with HIV/AIDS and immunosuppression levels by measuring clusters of differentiation 4 (CD4) cell counts among patients living in the middle western regions of Ghana.
Materials and Methods: A total of 120 patients who visited the HIV clinic at the Komfo Anokye Teaching Hospital and the Regional Hospital Sunyani of Ghana were consecutively enrolled in this prospective and cross-sectional study. Referred patients’ baseline CD4 counts were obtained from medical records and each patient received an initial physician assessment. Intraoral diagnoses were based on the classification and diagnostic criteria of the EEC Clearinghouse, 1993. After the initial assessment, extra- and intraoral tissues from each enrolled patient were examined. Data analyses were carried out using simple proportions, frequencies and chi-square tests of significance.
Results: Our study included 120 patients, and was comprised of 42 (35.0%) males and 78 (65.0%) females, ranging in age from 21 to 67 years with sex-specific mean ages of 39.31 years (males) and 39.28 years (females). Patient CD4 count values ranged from 3 to 985 cells/mL with a mean baseline CD4 count of 291.29 cells/mL for males and 325.92 cells/mL for females. The mean baseline CD4 count for the entire sample was 313.80 cells/mL. Of the 120 patients we examined, 99 (82.5%) were observed to have at least one HIV-associated intraoral lesion while 21 (17.5%) had no intraoral lesions. Oral candidiasis, periodontitis, melanotic hyperpigmentation, gingivitis and xerostomia were the most common oral lesions.
Conclusion: From a total of nine oral lesions, six lesions that included oral candidiasis, periodontitis, melanotic hyperpigmentation, gingivitis, xerostomia and oral hairy leukoplakia were significantly correlated with declining CD4 counts.
Keywords: Oral manifestations, HIV, Acquired immune deficiency syndrome, Cluster of differentiation 4 (CD4) cells

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31 August 2017
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