The correlation of pathognomonic periodontal manifestation with CD4+ level in people live with Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome in a Tertiary Hospital, Surabaya, Indonesia

Abstract

Aim: The prevalence of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients worldwide continue increasing annually, thus it has become a global health problem and burden. An oral manifestation can be used as the clinical biomarkers in people living with HIV/AIDS (PLWHA) using the pathognomonic periodontal manifestation, such as Necrotizing Ulcerative Gingivitis (NUG) and Necrotizing Ulcerative Periodontitis (NUP). This study aims to investigate the prevalence and correlation of pathognomonic periodontal manifestations with Cluster of Differentiation 4 (CD4+) level in PLWHA in a tertiary hospital, Surabaya, Indonesia. Materials and Methods: It presents an observational analytical study with a cross-sectional and total sampling method conducted from July to August 2014 in Dr. Soetomo General Tertiary Hospital. There were 88 HIV-seropositive patients who have not received any antiretroviral therapy yet who were recruited for this study. The patients and their guardians were explained about the study aims and participation approval which was obtained by the written informed consents. The diagnosis of NUP and NUG in PLWHA was based on its clinical features. The CD4+ level the latest 6 months was obtained from medical record as a retrospective data. The correlation between low CD4+ levels with pathognomonic periodontal manifestation in PLWHA was analyzed by Spearman s correlation test. Results: There are 9 (10.23%) PLWHA with pathognomonic periodontal manifestation, 7 (77.7%) with NUG, and 2 (22.3%) with NUP. All PLWHA (100%) have low CD4+ level (<200 cell/mm3). The Spearman s correlation shows that there are a correlation between pathognomonic periodontal manifestation with CD4+ level in PLWHA (r = −0.464) (P = 0.03; P < 0.05). Conclusion: NUG and NUP are pathognomonic periodontal manifestation found in Indonesian PLWHA which are associated with low CD4+ level reflecting the immune suppression level, and it can be used to predict HIV/AIDS stage of progression.