Oral normal variations and lesions in a Ugandan cohort of people living with Human Immunodeficiency Virus

Abstract

BACKGROUND: The enhanced availability of highly active antiretroviral therapy (HAART) has led to an increase in the longevity of people living with HIV (PLHIV). This has given us a chance to see the effects of physiological aging along with long-term use of HAART. Additionally, the HAART may also bring in side effects that manifest orally. Additionally, HIV/AIDS is known to increase the prevalence of certain oral mucosal lesions with some of these, indicative of the level of immune suppression. Therefore, in a population on HAART, some oral manifestations may be a mark of treatment failure.METHODS: The study population included in this study was PLHIV receiving care at Mulago Immune Suppression Syndrome Clinic under Makerere University Joint AIDS Program (MJAP). Using consecutive sampling, we recruited 4548 participants. After getting their informed consent, we administered health questionnaires, collected their treatment history, and performed oral mucosal clinical examinations.RESULTS: Of all the participants (N.=4548) 69.8% female, mean and median age were 44.2±1.7 and 44.0±2 years for female and male respectively, 32.0% (N.=1457) had some mucosal changes, the men had more of these variations and lesions compared to women (40.5%, N.=556 vs. 28.5%, N.=901 P=0.001). One change was registered in 24.9% (N.=1133), two in 6.1% (N.=276) and three in 0.9% (N.=40) of the participants. Overall, 45 different kinds of changes were recorded; 32.2% were diagnosed as potentially premalignant lesions while 33.8% were inflammatory in nature. 15.7% belonged to the HIV-associated category and 15.4% were considered to be normal variations. The oral condition that was most prevalent in the studied population was leukoplakia and the least frequent was xerostomia.CONCLUSIONS: In this PLHIV cohort, close to a third of the population had some form of oral mucosal variations and/or lesions. This was comparable to other populations close enough to our study population.