The impact of oral manifestations of HIV/AIDS on the quality of life of patients living with HIV/AIDS

Bajomo, Abiodun Sunday
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ABSTRACT The United Nations Programme on HIV/AIDS estimates that over 40 million people are living with HIV/AIDS globally. An estimated 15,000 new infections occur each day, with more than 95% of these in developing countries. Sub-saharan Africa currently bears the greatest burden worldwide with 28.5 million (70%) individuals infected. In South Africa 5.2 million of the population was estimated to be infected with HIV/AIDS. Between 60% and 90% of people with HIV infection will have at least one oral manifestation at some time during the course of their disease. Oral lesions cause significant discomfort and have a major impact on quality of life. Recognition and management of these oral conditions is therefore important for the health and quality of life of the individual with HIV/AIDS. Despite the increasing number of reports on the prevalence of oral manifestations in HIV positive/AIDS patients, there is limited information about the impact of these lesions on quality of life in these patients. This research report assessed the impact of oral manifestations of HIV/AIDS on the quality of life of people living with HIV/AIDS. The objectives were to determine the oral condition of patients living with HIV/AIDS, determine patterns of utilization of oral health care facilities by these patients and explore the relationship between oral conditions in HIV/AIDS individuals and oral health related quality of life (OHRQoL). Participants included 175 consecutively consenting HIV-infected adults who presented at a Johannesburg Hospital’s outpatient HIV-clinic during the period of the study, after receiving counseling about their HIV status. Data was collected using a structured selfadministered questionnaire containing items on socio demographic characteristics, antibiotic treatment and items from an adapted instrument for measure of OHRQoL-Oral Health Impact Profile (OHIP). An oral examination was carried out on all the respondents by a trained examiner who was blinded to the completed questionnaire. The presence of HIV-related lesions and DMFT scores were recorded. V Of the respondents, 108 (61.7%) were on antibiotic treatment and 133 (76%) presented with at least one oral lesion. A total of 109 (62.3%) presented with multiple lesions, one hundred (57.1%) presented with pseudomembraneous candidiasis which was the most common lesion. Oral ulcers were present in 30 (17.1%) of the study population. Only one participant was diagnosed with Kaposi’s sarcoma. The OHRQoL of those presenting with oral manifestations was statistically significantly lower than those without oral manifestation (Mean OHIP score of 32.3 Vs 23.3; p<0.05). Presenting with multiple lesions and being female were significant predictors of lower OHRQoL. The internal reliability for the OHIP used to measure OHRQoL was high, with a Cronbach alpha value of 0.92. Oral manifestation in HIV significantly reduces quality of life. There is an urgent need for appropriate service planning to manage oral lesions in HIV in hospital or clinic settings.