ORAL MANIFESTATIONS OF HIVIAIDS IN A KENYAN PROVINCIAL HOSPITAL
Abstract
Background: In Kenya many patients exposed to the HIV infection present with orofacial
lesions as the primary manifestations of the disease and only a few studies have been
performed to document this observation.
Objective: To clinically evaluate and document the range and pattern of oral lesions in a
group of hospitalised patients with HIV-infection.
Design: A prospective study.
Setting: Coast Province General Hospital in Mombasa, Kenya, which is the main referral
institution serving a population of approximately two million people.
Methods: Examination of all the cases included in the study was performed according to the
WHO criteria. Both male and female patients aged 16 years and above were selected. The
criterion of recruitment was based on a suspicion of immunosuppresion, the presence of oral
manifestations and the willingness to participate in the stud). Prior to the examination each
patient had undergone co~~nselling followed by two consecutive screening tests using the
ELISA technique. Where indicated incisional biopsy was performed to confirm the clinical
diagnosis of the relevant lesions. In collaboration with the medical team, treatment was
administered as per the needs of the patient in terms of anti-fungals, antivirals or topical
cortisteroids.
Results: Of the 61 cases, 25(41% ) were males and 36(59% ) females with an age range of 19
to 65 years (mean = 34.7years). While all the cases had periodontal disease, over 80% had
candidiasis of the hyperplastic. erythematous and pseudomembraneous types.
Lymphadenopathy and angular cheilitis were each diagnowd in 27.9% of the cases; while
oral Kaposi's sarcoma wa9 seen in 13% of the patients. Other conditions seen included
persistent oral ulceration (1 1.5% ),oral hairy leukoplakiaand herpes zostereachconstituting
4.9%; herpes simplex, mucosal hyperpigmentation, parotomegaly and facial palsy each
comprised six per cent and oral warts seen in one case. In accordance with the pattern and
prevalence of oral manifestations in our study, the results were largely consistent with those
documented elsewhere.
Conclusion: For the alleviation of the morbidity arising from the commonly occurring
lesions, early detection is mandatory. Furthermore, documc.ntation of the varied regional
patterns of occurrence of these lesions may aid in the rational application of the emerging
treatments.
lesions as the primary manifestations of the disease and only a few studies have been
performed to document this observation.
Objective: To clinically evaluate and document the range and pattern of oral lesions in a
group of hospitalised patients with HIV-infection.
Design: A prospective study.
Setting: Coast Province General Hospital in Mombasa, Kenya, which is the main referral
institution serving a population of approximately two million people.
Methods: Examination of all the cases included in the study was performed according to the
WHO criteria. Both male and female patients aged 16 years and above were selected. The
criterion of recruitment was based on a suspicion of immunosuppresion, the presence of oral
manifestations and the willingness to participate in the stud). Prior to the examination each
patient had undergone co~~nselling followed by two consecutive screening tests using the
ELISA technique. Where indicated incisional biopsy was performed to confirm the clinical
diagnosis of the relevant lesions. In collaboration with the medical team, treatment was
administered as per the needs of the patient in terms of anti-fungals, antivirals or topical
cortisteroids.
Results: Of the 61 cases, 25(41% ) were males and 36(59% ) females with an age range of 19
to 65 years (mean = 34.7years). While all the cases had periodontal disease, over 80% had
candidiasis of the hyperplastic. erythematous and pseudomembraneous types.
Lymphadenopathy and angular cheilitis were each diagnowd in 27.9% of the cases; while
oral Kaposi's sarcoma wa9 seen in 13% of the patients. Other conditions seen included
persistent oral ulceration (1 1.5% ),oral hairy leukoplakiaand herpes zostereachconstituting
4.9%; herpes simplex, mucosal hyperpigmentation, parotomegaly and facial palsy each
comprised six per cent and oral warts seen in one case. In accordance with the pattern and
prevalence of oral manifestations in our study, the results were largely consistent with those
documented elsewhere.
Conclusion: For the alleviation of the morbidity arising from the commonly occurring
lesions, early detection is mandatory. Furthermore, documc.ntation of the varied regional
patterns of occurrence of these lesions may aid in the rational application of the emerging
treatments.
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