Comparison of oral manifestations with CD4 count in HIV-infected patients.

Aim and Objective: This study was carried out with the primary aim of correlating oral changes and general changes of HIV-infected patients with their CD4 count. Materials and Methods: 124 patients were selected, and after taking their informed consent, they were subjected to detailed history taking and thorough clinical examination. Specific oral lesions and general physical changes were recorded. Every patient was subjected to laboratory investigation for CD4 count. All these findings were tabulated. The clinical observation and laboratory findings were subjected to critical analysis and correlated. Statistical test, i.e. Student's " t" test, was applied and objective conclusions were drawn. Result: Out of 124 patients, 40 had oral candidiasis, 6 had oral hairy leukoplakia, 12 had periodontal disease, 20 had xerostomia, 30 had melanin pigmentation, while 4 had HSV2, and atypical ulceration. Out of 40 patients with oral candidiasis, 28 patients had CD4 count <200 (group A), 10 patients were in group, B (CD4 count 200-500 cell/mm 3 ) and 2 patients in group C(CD4 >500 cell/mm 3 ). Oral hairy leukoplakia occurred in equal proportions in group A and B. These periodontal diseases were more commonly in group B; xerostomia and melanin pigmentation was equally seen in group A and B. Conclusion: Oral candidiasis, oral hairy leukoplakia, linear gingival erythema, necrotizing ulcerative gingivitis, and necrotizing ulcerative periodontitis are specific oral indicators which will definitely suggest to the dental surgeon that the disease is running a rapid downhill course and due to this the oral physician is in a position to raise a suspicion and alert the general physician regarding the declining immune status of patient.

Valoración del estado inmunológico en niños con gingivoestomatitis herpética aguda / Assessment of the immunological state in children with acute herpetic gingivostomatitis

Se realizó un estudio en 30 niños atendidos en el Servicio de Cirugía Maxilofacial del Hospital Pediátrico William Soler con el diagnóstico de gingivoestomatitis herpética aguda (GEHA) con el objetivo de conocer su estado de inmunocompetencia celular. La edad promedio fue de 3,7 años; se afectaron ambos sexos por igual, con un promedio de los enfermos de raza blanca sobre los de raza negra. Encontramos el 83 por ciento de los pacientes con algún grado de defecto en los marcadores de inmunidad estudiados (rosetas activa y espontánea), de los cuales 22 mostraron cifras anormalmente bajas en los 2 marcadores y 3 en 1 marcador. Entre los pacientes que presentaron enfermedad de debut, en total 9, hubo 5 con valores dentro de límites normales y los restantes con ambos marcadores afectados. En los casos de recidiva, que fueron 21, el 100 por ciento presentó al menos 1 marcador afectado. Puede considerarse, por lo tanto, el déficit inmunológico celular como factor predisponente o secundario a la infección por herpes simple tipo I(AU)

30 children who received medical attention at the Maxillofacial Surgery Service of William Soler Pediatric Hospital with the diagnosis of acute herpetic gingivostomatitis (AHGS) were studied in order to know their cellular immunocompetence state. Average age was 3.7 years old. Both sexes were affected. A prevalence of white patients was observed. 83 percent of the patients had some degree of defect in the studied immunity markers (active and spontaneous rosettes). 22 of them showed abnormally low figures in the 2 markers, and 3 in only one. 5 of the 9 patients with debut disease had values within the normal limits, whereas the rest had both markers affected. Among the patients with relapse that were 21, 100 %, presented at least one affected marker. herefore, the cellular immunological deficit may be considered as a predisposing or secondary factor to the infection caused by herpex simplex type 1(AU)

effect of idoxuridine treatment on the antibody level in herpetic stomatitis cases, using the enzyme linked immunosorbent assay [ELISA]

Sixty four children clinically diagnosed as having herpetic gingivo stomatitis were included in the study. Scrapings from the lesions were inoculated on vero cell tissue culture cells for HSV isolation. Acute and convalescent sera were collected from all patients as well as from 50 control children. 45 HSV isolates were obtained. Half of these cases received idoxyuridine local ointment and the other half had 1% gentian violet paint. Antibodies were tested by the enzyme linked immunosorbent among [ELISA] using goat horse radish peroxidase cenjugate antihuman IgG as a substrate optical density was measured by Dynatech microplate ELISA reader at 410 nm filter. Significant difference was detected between the acute convalescent HSV antibody titer. The difference between HSV antibody titers in those received IDU and gentian violet was found to be statistically non significant. It was concluded that IDU acts only locally and has no remote or systemic effect on the virus or the antibody production capacity