Prevalence of oral and perioral manifestations in HIV positive adults at Tikur Anbessa Teaching Hospital Addis Ababa, Ethiopia.

BACKGROUND: Oral lesions are often characteristic in HIV patients and in the majority of cases can be diagnosed by their clinical features alone. To date there is no study addressing the prevalence of oral and perioral lesions in HIV patients in Ethiopia.

OBJECTIVES: To assess prevalence of oral and perioral manifestations, the clinical symptoms of oral disease, and to assess the association of oral and perioral lesions to the socio- demographic status and CD4 count of ART naive HIV patients.

METHODS: A cross-sectional study on 384 consecutive HIV patients before initiation of ARV treatment was conducted. Oral and perioral lesions were diagnosed according to the EC-clearinghouse's classification and diagnostic criteria for oral lesions in HIV infection and WHO collaborating centre on oral manifestations of HIV, 1992.

RESULTS: One hundred and twenty six (32.8%) of the study subjects were males and 258 (67.2%) were females and mean age was 35.4 +/- 9.94 years (range of 14-84 years). Overall prevalence of oral lesions was 64.3%, and perioral lesions was 15.4%. Nearly half (44%) had dental caries. Pseudomembraneous candidiasis (20.1%), linear gingival erythema (11.7%), and erythematous candidiasis (9.1%) were the three most common HIV associated oral lesions. Angular cheilitis (8%) and molluscum contagiosum (4%) were the two most common perioral conditions. The most common oral symptoms reported were dry mouth (34.4%), difficulty eating (27.9%), and oral pain (27.3%). Oral symptoms and a CD4 count < 200 mm(-3) were significantly (X2 = 22.4, P = 0.0001) associated with presence of oral and perioral lesions. Age above 40 years (31%) was significantly associated with oral lesions (P = 0.016), but not with perioral lesions (P = 0.26).

CONCLUSION: Oral and perioral lesions were common in HIV positive adults at Tikur Anbessa Specialized hospital and represent a treatable morbidity associated with this disease. Thus, a comprehensive oral examination is important in the clinical evaluation, management, and follow up of patients with HIV.