Gannepalli Ashalata, Krishna Ayinampudi B, Baghirath Pacha V, Vinay Balistty Hari, Khaled Sana, Anjum Bushra
Department of Oral and Maxillofacial Pathology, Panineeya Mahavidyalaya Institute of Dental Sciences, Dilsukhnagar, Hyderabad, Telangana, India.
J Int Soc Prev Community Dent. 2020 Jan 24;10(1):21-35. doi: 10.4103/jispcd.JISPCD_448_18. eCollection 2020 Jan-Feb.
Human immunodeficiency virus (HIV)-related oral lesions are often an early finding, and they reflect the underlying immunosuppression, and tuberculosis (TB) coinfection can have further deteriorating effect. Hence, a cross-sectional study was conducted to evaluate clinical and oral presentations of patients coinfected with HIV-TB, correlating with various parameters such as the type of TB with CD4 cell count, the type of TB with oral manifestations, site of the lesion, oral manifestations with CD4 cell counts, age, and gender.
A cross-sectional study was conducted among selected 200 patients coinfected with HIV-TB, registered at Gandhi Medical College, Hyderabad, Telangana, India, and demographic data, CD4 count, diagnosis of TB, and clinical presentation of TB were correlated with site, age, gender, and the type of lesions in the oral cavity. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) software, (IBM SPSS), version 20 (Chicago, IL, USA), with the chi-square test, and the significant value for all the parameters was considered as <0.05.
A total of 200 patients with HIV-TB coinfection, who presented with oral lesions of 258 coinfected cases, were examined. Among which, 129 patients were with pulmonary tuberculosis (PTB), 61 patients with extrapulmonary TB, 2 patients with disseminated TB, and 8 patients with PTB and pneumonia. There were multiple oral manifestations involving different sites of oral cavity, oral candidiasis (28.5%), angular cheilitis (24.5%), linear gingival erythema (21.5%), oral hairy leukoplakia (1.5%), melanotic pigmentation (29.0%), ulcers (20.0%), depapillation of tongue (26.5%), lobulated tongue (12.0%), hairy tongue (11.5%), and papules (10.0%). The correlation of the type of TB with CD4 cell count, oral lesions with the type of TB in tongue, labial mucosa, and palate was significant.
A total of 77.5% patients coinfected with HIV-TB had shown oral manifestations emphasizing that the presence of oral lesions can be considered as a strong indicator of coinfection. The oral lesions might be used as a clinical indicator or screening mechanism in patients who were HIV seropositive for TB coinfection and should be necessarily evaluated for TB.
人类免疫缺陷病毒（HIV）相关的口腔病变常常是早期发现，它们反映了潜在的免疫抑制情况，而合并感染结核病（TB）会产生进一步的恶化影响。因此，开展了一项横断面研究，以评估HIV-TB合并感染患者的临床和口腔表现，并将其与各种参数相关联，如结核病类型与CD4细胞计数、结核病类型与口腔表现、病变部位、口腔表现与CD4细胞计数、年龄和性别。
在印度特伦甘纳邦海得拉巴市甘地医学院登记的200例HIV-TB合并感染患者中开展了一项横断面研究，将人口统计学数据、CD4计数、结核病诊断和结核病临床表现与口腔部位、年龄、性别以及口腔病变类型相关联。使用社会科学统计软件包（SPSS）软件（IBM SPSS）20版（美国伊利诺伊州芝加哥）进行数据分析，采用卡方检验，所有参数的显著值被认为<0.05。
共检查了200例HIV-TB合并感染且出现口腔病变的258例合并感染病例。其中，129例为肺结核（PTB），61例为肺外结核，2例为播散性结核，8例为PTB合并肺炎。口腔出现多种累及口腔不同部位的表现，口腔念珠菌病（28.5%）、口角炎（24.5%）、线性牙龈红斑（21.5%）、口腔毛状白斑（1.5%）、黑色素沉着（29.0%）、溃疡（20.0%）、舌乳头萎缩（26.5%）、分叶舌（12.0%）、毛舌（11.5%）和丘疹（10.0%）。结核病类型与CD4细胞计数以及舌、唇黏膜和腭部的口腔病变与结核病类型之间的相关性显著。
77.5%的HIV-TB合并感染患者出现了口腔表现，强调口腔病变的存在可被视为合并感染的有力指标。口腔病变可作为HIV血清学阳性患者合并感染结核病的临床指标或筛查机制，并且应对其进行结核病的必要评估。
