Oral HIV lesions and oral health behaviour of HIV-positive patients attending the Queen Elizabeth II Hospital, Maseru, Lesotho.

AIM: The aim of the study was to determine the prevalence of oral mucosal lesions strongly associated with HIV infection and to assess the oral health behaviour among patients attending Queen Elizabeth II Hospital in Maseru. The objectives were: (i) to determine the prevalence of group 1 lesions in HIV-positive patients according to the ECC/WHO classification; (ii) assess the oral hygiene practices of these patients; and (iii) make recommendations based on the findings.
METHODOLOGY: A questionnaire was administered by an interviewer to a sample of 270 patients with a serological diagnosis of HIV infection to assess their oral health behaviour; they were then examined for oral manifestations. The assessment of oral health behaviour involved determining the regularity and frequency of oral hygiene practices, and use of mouth wash, interdental and other adjunct cleaning aids. The presumptive criteria as defined by the ECC/WHO classification were used for diagnosis of the oral mucosal lesions. Results were entered and analysed using Epi info-6 statistical software
RESULTS: The prevalence of specific oral mucosal lesions in order of occurrence was pseudomembranous candidiasis 27%, erythematous candidiasis 26%, angular cheilitis 14%, hairy leukoplakia 12%, ulcerations 12%, necrotising gingivitis 5%, linear gingival erythema 3%, and non-Hodgkin's lymphoma and Kaposi's sarcoma less than 1%. This pattern reflects the findings in other regional studies where pseudomembranous candidiasis is often the most common lesion found. Nearly all patients reported cleaning their mouths; 82% did it every day. Mouth wash and interdental cleaning aids were not often used.
CONCLUSIONS: A high prevalence (73%) of oral mucosal lesions was found. Oral candidiasis was the most common group of lesions (54%). The oral hygiene practices reported by the patients were considered acceptable.