Oral mucosal lesions and immune status in HIV-infected Indian children.

OBJECTIVE: Pediatric HIV is growing at an alarming rate in developing countries. Due to their compromised immune status, children infected with HIV are prone to a number of opportunistic infections. Oral manifestations are the first signs of the disease in many of them. To assess the oral mucosal status of Indian children with HIV, based on their CD4 cell counts. METHODOLOGY: Two hundred and twenty one HIV infected children aged 6-18 years from various HIV centers, were divided into three groups, based on their CD4 cell counts; Group 1: >/=500, Group 2: 201-499 and Group 3: </=200 cells. The children in each group were further considered as 'prior to antiretroviral treatment (ART)' and 'on ART'. Oral mucosal examination was done based on presumptive criteria given by Ramos-Gomez for diagnosis of oro-facial lesions commonly associated with HIV infection in children. Data obtained was subjected to statistical analysis. RESULTS: Angular cheilitis and pseudomembranous candidiasis were the frequently seen oral lesions. Children with CD4 cell count >/=500 had significantly fewer oral lesions each. CONCLUSION: A high percentage of HIV-infected children were affected with oral mucosal lesions. There was a significant association between immune status and frequency of oral lesions.