The occurrence of oral manifestations in HIV infected patients at Pumwani Maternity Hospital, Nairobi, Kenya

Abstract

The study involved 160 patients attending the ante-natal clinic of Pumwani Maternity Hospital between February and April, 1990. Of these 80 (50%) were confirmed to be HIV infected (referred to as cases) and the other 80 (50%) were not (referred as controls). In the cases, 60(75%) and in the controls, 59(73.8%) were between the ages 20-28 years. The only risk behaviour for HIV infection appeared to be heterosexual contact. with the controls, 71 (88.8%) were married whereas 8(10%) were single. with the cases, 65(81.25%) were married and 15(18.75%) were single. They were predominantly of low social economic status.Only 3(3.80%) of the controls, and 1(1.25%) of the cases,had attained A-Ievel (form six) education and above. Out of the 160 examined,there was only one graduate. All patients examined were in group 2 i.e asymptomatic infection, according to Centres for Disease Control classification. The number of controls with oral candidiasis was 22 (27.5%) compared to 50 (62.5%) ln the cases(P=0.0003). A total of 14(17.5%) of the controls had bacterial infections i.e . gingivitis and periodontitis, whereas 42 (52.5%) of the cases had similar infections(P=O.OOOl). Eighteen (22.5%) of the controls had hyperpigmentation of the oral cavity mucosa compared to 38 (47.5%) of the cases(P=0.0016f. There were five(6.3%) of the cases who had herpetic stomatitis and non in the controls, whereas there were eight(10.2%) of the cases with hairy leukoplakia-like lesions and two(2.5%) of the controls had similar lesions(P=0.0141). There were

15 (18.8%) of the cases who had lesions with clinical features of kaposi's sarcoma but this was not confirmed histologically. Two individuals in the control had such lesions also(P=O.0021). These lesions were predominantly in the palate. A few of the individuals in the study were involved in habits which are known to have an effect in the oral cavity but the numbers were too small to be of any statistical importance. For example, twelve individuals(four controls and eight cases) admitted that they drink alcohol, three cases were mirra chewers, two cases were smokers and one control was using unspecified drugs habitually. There were no cases of aphthous ulcerations but two controls and one case had xerostomia. Oral Candidiasis, Periodontal Disease (Gingivitis and Periodontitis) and Hyperpigmentation were all associated with asymptomatic HIV infection.