Assessment of Risk Behaviors and Factors Associated with Oral and Peri-oral Lesions in Adult HIV Patients at Tikur Anbessa Specialized Hospital; Addis Ababa; Ethiopia

ABSTRACT

Background: HIV patients have several habits that can produce oral lesions. However; the association of oral habits and risk behaviors with oral and peri-oral lesions in HIV patients has not been studied in Ethiopia to date. Objective: To assess the relationship of oral and peri-oral lesions with oral habits; risk behaviors; socio-demographicfactors and clinical stages of disease among HIV infected adult Ethiopians. Methodology A cross-sectional study was conducted on consecutive adult ART naive HIV patients at ART clinic of Tikur Anbessa Specialized University Hospital; Addis Ababa; Ethiopia during December 2005 to July 2006. The EC-clearing house's classification and diagnostic criteria for oral lesions in HIV infection was used. Written informed consent was obtained before enrollment to the study. Results A total of 384 patients; 126 (33) males and 258 (67) females were evaluated. The mean + SD age of males was 39.9 +10.56; and females was 33.17 + 8.85 years. Fifty seven (15) of the unit of analysis were smokers; 178 (46) alcohol consumers and 217(57.1) khat chewers; use tooth sticks for dental cleaning. Of which; 132 (34.7) clean their teeth at least once a day and 302 (79) gave history of recent significant weight loss. Linear regression analysis showed association of oral and peri-oral lesions with less frequent cleaning (p=0.038; p=0.03; respectively); means of cleaning (p=0.004; p=0.001); broad-spectrum antibiotic use (p=0.019; p=0.008); advanced stage of HIV (p=0.016; p=0.001) and CD4 level below 200 Cells/mm3 (p=0.001; p=0.01). The oral lesions were seen more frequently among smokers (p=0.028); heavy alcohol consumers (p=0.041); those with age above 40 years (p=0.016) and recent weight loss (p=0.001). At the level of binary logistic regression analysis smoking (p=0.005); CD4 count less than 200 (p=0.039) and stage 3 (p=0.022) and stage 4 disease (p=0.046) were found to be independent risks while daily dental cleaning habit was found to be protective (p=0.021). Conclusion Oral and peri-oral diseases among HIV/AIDS patients and are significantly associated with correctable risk factors like smoking and poor oral cleaning habits. Lesions are also frequent with evidence of advanced HIV disease and low CD4 count. These findings demonstrate the need for oral health examination and education to improve on risk behaviors and oral care in HIV/AIDS patients