Oral conditions and their social impact among HIV dental patients, 18 years on

The Association Between Oral Mucosal Lesions and Oral Health-Related Quality of Life Using the Validated Indonesian Version of OHIP-14 Among People Living with HIV/AIDS

Background

Oral mucosal lesions in human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) patients, posing a concern for healthcare professionals, impact their oral health-related quality of life (OHRQoL). This study aimed to evaluate the association between oral mucosal lesions and OHRQoL as measured by the validated Indonesian version of the oral health impact profile-14 questionnaire (OHIP-14) among people living with HIV/AIDS (PLWHA).

Methods

A cross-sectional study was conducted at the Central Referral Hospital in West Java, Indonesia. The validity of OHIP-14 was evaluated in 30 PLWHA using inter-item corrected correlation, while reliability was assessed through Cronbach's alpha and kappa coefficient agreement. Subsequently, a consecutive sample of 110 PLWHA self-completed the validated Indonesian version of OHIP-14 and underwent an oral examination. The association between oral mucosal lesions and OHRQoL was analyzed using the chi-squared test.

Results

The validity test of the OHIP-14 questionnaire produced a rcount > 0.189, meaning that all question items were valid and could be used to describe OHRQoL. The reliability test of the OHIP-14 questionnaire produced a Cronbach's alpha value of 0.960 (> 0.7), which means that overall, the OHIP-14 questionnaire is reliable and feasible to be used to assess OHRQoL. Among the 110 enrolled participants, 61.8% were female and 38.2% were male, with the mean age 23.5 years old, the majority of them (59.1%) had been taking antiretrovirals (ARV), and (81.5%) had good QoL. There was a statistically significant relationship between oral lesions and quality of life (p<0.05), particularly acute pseudomembranous candidiasis, angular cheilitis, recurrent intraoral herpes, and Stevens-Johnson syndrome.

Conclusion

This study indicated a significant association between oral mucosal lesions and OHRQoL in PLWHA. The successfully validated Indonesian version of the OHIP-14 questionnaire serves as a reliable and effective tool for assessing OHRQoL among PLWHA.

Associated oral manifestations with HIV southeastern Brazilian patients on antiretroviral therapy

OBJECTIVES

This study aimed to assess the prevalence of oral lesions in patients living with HIV infection and their association with CD4 count, viral load, and antiretroviral therapy in patients with HIV.

METHODS

A cross-sectional study was conducted on a sample of 161 patients attending the… All the patients were examined for their oral lesions, current CD4 counts, type, and duration of the therapy. Data analyses were carried out using Chi-Square, Student T/Mann-Whitney, and logistic regression tests.

RESULTS

Oral lesions were observed in 58.39% of patients with HIV. Periodontal disease with 78 (48.45%) or without mobility 79 (49.07%) was observed more frequently, followed by hyperpigmentation of oral mucosa 23 (14.29%), Linear Gingival Erythema (LGE) 15 (9.32%), candidiasis pseudomembranous 14 (8.70%). Oral Hairy Leukoplakia (OHL) was observed only in 3 (1.86%). A relationship between periodontal disease with dental mobility and smoking was found (p=0.04), as well duration of treatment (p=1.53e-3) and age (p=0.02). Hyperpigmentation was related to race (p=0.01) and smoking (p=1.30e-6). CD4 count, CD4:CD8 ratio, viral load, or type of treatment were not associated with oral lesions. Logistic regression showed that the duration of treatment has a protective effect on the periodontal disease with dental mobility (OR = 0.28 [-2.27 to -0.25]; p-value=0.03), independent of age or smoking. To hyperpigmentation, the best model included smoking (OR=8.47 [1.18-3.10], p= 1.31e-5), without race or type and duration of treatment.

CONCLUSION

Among HIV patients undergoing antiretroviral treatment, oral lesions can be observed, predominantly periodontal disease. Pseudomembranous candidiasis and oral hairy leukoplakia were also observed. No relationship was found between associated oral manifestations in HIV patients and the start of the treatment, TCD4+ and TCD8+ cell count, TCD4:TCD8 ratio, or viral load. The data indicate that there is a protective effect of duration of treatment with relation to periodontal disease with mobility and that hyperpigmentation seems to be more related to smoking than type and duration of treatment.

LEVEL OF EVIDENCE

Level 3 (OCEBM Levels of Evidence Working Group*. "The Oxford 2011 Levels of Evidence").

Special Care Patients and Caries Prevalence in Permanent Dentition: A Systematic Review

Due to the increase in the population with special needs and the significant difficulty in their dental management, it is essential to analyze the caries prevalence in this group of patients. The systematic review was conducted following the PRISMA statement. A search was performed on 9 May 2022 and updated on 5 June 2022, in three databases: Pubmed, Scielo, and Cochrane library. Studies involving the analysis of caries in permanent teeth in patients with special needs were included. A total of 1277 studies were analyzed and 21 studies were selected. Quality assessments were performed using an adapted version of the STROBE guidelines. Among the analyzed groups (intellectual disabilities, human immunodeficiency virus infection, schizophrenia, down syndrome, drug addicts, adult heart transplant, kidney disease, diabetic, autism, psychiatric patients, cerebral palsy, and hemophilia), the highest prevalence of caries was observed in patients with intellectual disability, without differences between genders. However, there is a need for more studies with standardized methods for caries diagnosis to further investigate the prevalence of caries in permanent teeth in patients with special needs.

Caries experience by socio-behavioural characteristics in HIV-1-infected and uninfected Ugandan mothers - a multilevel analysis

OBJECTIVES

To assess caries experience in Ugandan mothers according to HIV status, socio-behavioural-characteristics, gingival bleeding status and to examine whether HIV status impacts the association of socio-behavioural characteristics with caries experience. Third, using multilevel analysis, this study assessed to what extent surface-specific caries experience varied between and within individuals.

MATERIALS AND METHODS

Caries experience was recorded using the World Health Organization's Decayed, Missed and Filled Teeth/Surfaces indices from a cohort of 164 HIV-1-infected Ugandan mothers and a cross sectional comparison group of 181 negative controls. Mixed-effects logistic regression was conducted with surface-specific caries experience as the outcome variable.

RESULTS

The prevalence of caries in HIV-1-infected and uninfected mothers was 81% and 71%, respectively. Significant associations occurred between caries experience at surface level and women's increasing age (odds ratio [OR] = 1.8, 95% confidence interval [CI]: 1.1-2.8) and presence of gingival bleeding (OR = 2.0, 95% CI: 1.2-3.2). Intra-class correlation (ICC) coefficient amounted to 0.54 (95% CI 0.48‒0.59).

CONCLUSIONS

Caries prevalence was higher in HIV-1 infected than in uninfected mothers and increased with age and gingival bleeding. ICC indicated that 54% of the variance was attributable to variation between individuals. Socio-demographic differences in dental caries did not vary by HIV-1 status.

The prevalence and socio-behavioural and clinical covariates of oral health related quality of life in Ugandan mothers with and without HIV-1

Background

There is limited evidence regarding oral health related quality of life of HIV positive populations in sub-Saharan Africa. Focusing HIV positive- and HIV negative Ugandan mothers, this study assessed the influence of HIV status on oral health related quality of life in terms of oral impacts on daily performances, whilst adjusting for clinical- and socio-behavioural factors. We also examined whether any association of clinical and socio-behavioural factors with oral impacts on daily performances vary according to mothers’ HIV status.

Methods

This cross-sectional study used data from a trial (n = 164) and a comparison group (n = 181). The trial comprised of mothers with HIV-1 participating in the ANRS 121741-PROMISE-PEP-trial (NCT00640263) conducted between 2009 and 2013 and from the ANRS 12341-PROMISE-PEP-M&S follow-up study conducted in 2017. The comparison group comprised of HIV negative mothers recruited in 2017. Interviews and clinical oral examinations were performed. The oral health related quality of life was assessed using the oral impacts on daily performances frequency scale. Caries experience and gingival bleeding were assessed using the World Health Organization’s Decayed, Missed and Filled teeth indices and community periodontal index. Logistic and negative binomial regression analyses were performed.

Results

29% of HIV-1 positive and 32% among the comparison reported any oral impact on daily performance. In adjusted logistic regression analysis, HIV status was not significantly associated with oral impacts on daily performances. Mother’s self-reported oral health, caries experience, gingival bleeding and oral health related quality of life of their children were independently associated with oral impacts on daily performances. Corresponding prevalence ratios and 95% confidence intervals were: 0.3 (0.2–0.6), 1.8 (1.0–3.2), 1.1 (1.0–1.1), and 2.1 (1.1–4.3). No significant interaction between HIV status and covariates were observed.

Conclusions

Oral health related quality of life was substantially impaired in Ugandan mothers but did not discriminate between HIV positive and negative participants. Mothers with impaired oral health related quality of life were more likely to have dental caries and children with impaired oral health related quality of life. HIV positive and negative mothers in Uganda deserve special attention regarding their oral disease and quality of life status.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12955-021-01844-3.

Oral health-related quality of life in patients infected with HIV, Iran: a cross-sectional study

Background

The life expectancy of patients with Human Immunodeficiency Virus (HIV) has increased, but its oral manifestations can affect the Oral Health-Related Quality of Life (OHRQoL) of these patients. This study aimed to evaluate OHRQoL in HIV-infected patients and determine its related factors.

Methods

In this cross-sectional study, 250 HIV-infected patients were randomly selected from Shiraz Voluntary Counseling and Testing center in 2019. OHRQoL was measured using the revised Geriatric Oral Health Assessment Index for HIV patients. The associations between patients’ OHRQoL and demographic characteristics were examined.

Results

The mean score of the patients' OHRQoL was 24.55 ± 6.27. The lowest and highest scores belonged to the psychosocial and pain categories, respectively. In the univariate analysis, the OHRQoL was significantly associated with patients' age (p = 0.012), duration of the disease (p = 0.009), job (p = 0.006), edentulous status (p = 0.003), and wearing denture (p < 0.001). However, in the multiple linear regression analysis, a significant difference was found only between denture wearing and non-denture wearing patients (p ≤ 0.001).

Conclusions

The OHRQoL of HIV-infected patients was not optimal since most of the patients were worried about their oral and dental health problems. The OHRQoL was significantly better in denture-wearing patients. This finding highlights the impact of unmet dental needs on OHRQoL in HIV-infected patients. Therefore, dental services coverage for patients with HIV is essential, so that they can have timely access to oral health care. Furthermore, dentures should be considered as an unmet healthcare need among HIV patients in public health policies.

Oral health related quality of life among HIV positive patients attending two HIV outpatient clinics in Nigeria - a cross sectional study

BACKGROUND

The human immunodeficiency virus infection remains a devastating disease of public health importance.

OBJECTIVES

To assess the association between oral health and quality of life and the factors affecting the oral health related quality of life among HIV positive patients in Nigeria.

METHODS

This was a cross sectional study of HIV positive patients attending two HIV outpatient clinics in Nigeria. Impact of oral health on quality of life was assessed using the OHIP-14. Oral health status was assessed by the DMFT and Simplified OHI indices. Level of significance was set at p< 0.05.

RESULTS

Three hundred and fifty-two patients were seen, 64.2% being females. Prevalence of impact was 8.5%; and the mean OHIP scores was 8.05±9.54. Highest impact was "painful aching" 67(19.1%) with the domain of physical pain scoring the highest mean impact of 2.32. Most patients (88.6%) were on HAART. Following logistic regression, after controlling for potential confounders, independent factors associated with poor OHRQoL were perceived need for dental treatment, HAART use, and higher DMFT (p<0.05).

CONCLUSION

The domain of physical pain had the highest impact, while perceived need for dental treatment, HAART use and higher caries index were contributory to poor OHRQoL.

HIV-1 impact on oral health-related quality of life: a cross-sectional study

This cross-sectional study compared the Oral-Health-Related Quality of Life (OHRQoL) in HIV negative patients (Group 1, n=129, mean age: 39.9 ± 15.6, 75 females) and HIV+ patients (Group 2, n=670, mean age: 43.2 ± 9.8, 246 females) from the same socio-economic environment using the OHIP-49 questionnaire. OHIP total score were determined by simple summing. A multiple linear regression model was carried out to predict OHIP scores in which HIV+ patients experienced a significantly (p<0.001) worst OHRQoL for total and every dimension. A general linear model was used for estimating the means in the two groups adjusted for covariates included in the previous model. Adjusted means for subscale and total OHIP scores were significantly higher for Group 2 (61.6 ± 6.26 vs. 119.8 ± 3.31) with a large effect size (0.94). HIV+ infection, decayed teeth, prosthodontic and surgical needs, care index, drug use, employment and age presented an independent effect on questionnaire scores. This study shows that HIV+ infection has an independent and negative impact on the OHRQoL while care index presents a positive impact. Additional factors like high decayed teeth, prosthodontic treatment needs and drug use are independently associated with total OHIP scores, presenting a negative effect on OHRQoL.

Salivary flow, amylase, and total protein in hospitalized patients with HIV infection / AIDS complications

BACKGROUND

Saliva is a complex secretion produced daily by the salivary glands. Saliva consists mainly of water, enzymes, ions and amino acids and performs several important functions in oral health.

OBJECTIVE

The aim of this study was to investigate the flow rate and concentrations of amylase and total proteins in the saliva of hospitalized patients due to AIDS complications.

METHODS

Ninety-three men and women (20-64 years of age) were divided into two groups (46 HIV-infected patients and 47 controls) and had salivary flow rate and levels of amylase enzyme and total proteins evaluated.

RESULT

The mean salivary flow rate was lower in individuals with HIV when compared to controls (P < 0.05). No significant difference between amylase enzyme levels and total proteins were observed in the saliva of patients with HIV infection when compared to controls.

CONCLUSION

Individuals with HIV / AIDS infection (in hospital treatment) suffer no interference in levels of amylase and total salivary proteins, but they have significantly reduced salivary flow.

Oral health and health-related quality of life in HIV patients

Background

Oral health care may improve the health-related quality of life (HRQoL) of HIV/AIDS patients. We aimed to evaluate oral health and HRQoL of HIV/AIDS patients using antiretroviral therapy.

Methods

A cross-sectional study included 120 HIV-infected patients, aged ≥18 years, from February, 2016 to September, 2017. The 36-Item Short Form Health Survey (SF-36) was used to evaluate the HRQoL. We assessed dental caries status using the Decayed, Missing and Filled Teeth (DMFT) index. Information about demographic, socioeconomic status, depression, and other comorbidities were collected. All patients with depression had a medical diagnosis. Comorbidities were defined as medical diagnoses of arterial hypertension, type-2 diabetes, tuberculosis, syphilis, cardiopathy, chronic renal failure, lymphoma, HCV infection, HBV infection and fatty liver disease. Independent t-tests were used to compare differences between mean levels of HRQoL, age, and DMFT and its components according to groups of sex, comorbidities and depression. Simple linear regression was used to analyze the relationship between the Mental Component Summary (MCS) and DMFT, and a multiple regression equation investigated depression, age, MCS, and comorbidities as predictors of DMFT.

Results

The mean DMFT index was 12.4 ± 8.2. A linear regression equation estimated a significant (p = 0.022) decrease of 0.25 unit (%) in MCS for each unit increase in DMFT. Among depressed patients, a significant (p = 0.008) decrease of 0.67% in MCS for each unity increase in DMFT was estimated. Depressed patients showed worse oral health indicators (DFMT index; p ≤ 0.001; and mean Missing Teeth; p ≤ 0.052) and lower HRQoL domains than non-depressed patients. DMFT remained associated with depression (P < 0.005) after controlling for age, MCS, and comorbidities.

Conclusions

We found association between poorer oral health (higher DMFT index) and lower Mental Health Component Summary in HIV-infected patients with depression. Patients with depression deserve especial attention to their HRQoL and oral care.

Oral status and periodontal microbiota of HIV-infected youth infected by vertical transmission

Aim: This study evaluated the oral status and microbiota of HIV+ youth infected by vertical transmission. Materials & methods: 34 HIV+ and 36 HIV- individuals (14–24 years of age) were examined for oral infections/lesions. Subgingival biofilm was collected and the microbiota determined by checkerboard DNA–DNA hybridization. Results: Over 90% of the HIV+ youth were under highly active antiretroviral therapy, but 64.6% had AIDS and 47% presented oral manifestations. HIV+ youth showed more periodontal attachment loss and inflammation than HIV- (p < 0.05), and also high prevalence of caries. Most species were detected in higher prevalence in the microbiota of HIV+ than controls. Conclusion: HIV+ youth infected by vertical transmission presented more periodontal destruction and inflammation, and greater prevalence of microbial pathogens compared with HIV- individuals.

Access and management of HIV-related diseases in resource-constrained settings: a workshop report

With advancement of medical interventions, the lifespan of people living with HIV has increased globally. However, low- and middle-income countries (LMICs) which bear the greatest burden of the HIV pandemic face a constant challenge in addressing the treatment needs of immune-suppressed patients. An analysis of the current management protocols and access to medication in resource-poor settings was conducted at this workshop, with emphasis on the situation in resource-poor settings. The participants developed a consensus document based on the need to respond to the constantly changing HIV pandemic. Provision of oral health care must be guided by interconnecting principles based on population based strategies that address upstream determinants of health. Basic oral health coverage in developing countries can only be realized with a strong foundation at the primary health level. Early diagnosis of HIV-related comorbidities including the adverse effects of ARVs is essential for the improvement of treatment outcomes. Standardization of oral health care delivery mechanisms will facilitate evaluation at national and regional levels. Oral health care workers have a moral obligation to participate in sustained campaigns to reduce the social stigma associated with HIV/AIDS in their work places at every stage of the referral chain. Future research also needs to realign itself towards prevention using the common risk factor approach, which has a broader impact on non-communicable diseases, which are increasingly affecting patients with HIV/AIDS as their life expectancies increase.

Association among oral symptoms, oral health-related quality of life, and health-related quality of life in a sample of adults living with HIV/AIDS in Malaysia

Background

Health-related quality of life (HRQOL) is a multidimensional construct that refers to an individual’s self-perceived well-being. This study used the revised Wilson and Cleary HRQOL model to investigate the associations among oral symptoms, oral health-related quality of life (OHRQOL), and HRQOL of people living with HIV/AIDS (PLWHA) in Malaysia.

Methods

A total of 121 PLWHA receiving medical care in Kota Bharu (Kelantan, Malaysia) participated in this cross-sectional study. The Malay version of the short Oral Health Impact Profile (S-OHIP(M)) and the Malay version of the 36-item Medical Outcome Study Short Form (SF-36) were used to assess OHRQOL and HRQOL, respectively. A higher S-OHIP(M) score indicates greater oral impact and worse OHRQOL; a higher SF-36 score indicates better HRQOL. An additional structured self-administered questionnaire was used to obtain other variables of interest from the participants.

Results

Most participants had at least one oral symptom (69.4%), and the most common oral symptom was a cavitated tooth (55.4%). The prevalence of oral impacts was 33.9%, and the mean S-OHIP(M) score was 8.8 (SD = 7.92). The mean S-OHIP(M) score was significantly higher in participants who had toothaches, cavitated teeth, gum abscesses, and bad breath. In addition, participants with lower S-OHIP(M) scores had significantly higher scores in all SF-36 domains.

Conclusions

Our study provides evidence for an association among oral symptoms, OHRQOL, and HRQOL in PLWHA from Malaysia. In particular, the presence of oral symptoms was significantly associated with more severe oral impacts and poorer OHRQOL. The presence of less severe oral impacts was associated with a better HRQOL.

Electronic supplementary material

The online version of this article (doi:10.1186/s12903-017-0409-y) contains supplementary material, which is available to authorized users.

Dental Health Status of HIV-Positive Patients and Related Variables in Southeast Iran

Background

Different factors can be responsible for the increased prevalence of dental caries and missing teeth in HIV-positive patients.

Objectives

This study evaluates dental health status and its relationship with social, behavioral, and medical factors in HIV-positive patients under the coverage of Zahedan University of Medical Sciences in Southeast Iran.

Patients and Methods

In a cross-sectional study, the dental health status of 119 HIV-positive patients was assessed in accordance with WHO indices and included decayed, missing, and filled teeth (DMFT). A questionnaire on different social, behavioral, and medical variables was filled out for every case and the relationship and correlation of the variables to dental health status were investigated using One-way ANOVA, the Kruskal Wallis test, the t-test, the Mann-Whitney test, Spearman’s rho correlation coefficient, and Pearson correlation.

Results

The mean value of DMFT index was 11.87 ± 8.08, where the mean values of decayed and missing teeth were 8.42 ± 5.44 and 3.43 ± 4.07, respectively. DMFT index, decayed, and missing teeth correlated only with age (P < 0.0001, P = 0.009, P < 0.0001) and duration of HIV involvement (P = 0.004, P = 0.031, P = 0.007).

Conclusions

The dental health status of HIV-positive patients in this region was almost inappropriate. Most social, behavioral, and medical factors had no influence on dental health; only a correlation between dental health, age, and duration of HIV involvement was observed.

Functional and psychosocial impact of oral disorders and quality of life of people living with HIV/AIDS

PURPOSE

This study compared the Quality of Life (QOL) according to the presence of functional and psychosocial impact of oral disorders and evaluated the convergent validity between the dimensions of the WHOQOL and the OHIP-14 scores among people living with HIV.

METHODS

This was a cross-sectional study with patients enrolled in reference centres of a midsize Brazilian city. Interviews were conducted when the participants arrived at the centres seeking services for medical appointments and collecting medicines. The OHIP-14 was used to evaluate the functional and psychosocial impact of oral disorders. QOL was assessed using the general issues and six domains of the WHOQOL-HIV BREF. The Chi square test, Mann-Whitney test, and Spearman correlation analysis were used for analysis.

RESULTS

The sample comprised 422 people living with HIV/AIDS (response rate: 81.2%). The prevalence of functional and psychosocial impact of oral disorders was 34.0%. The prevalence of very poor/poor QOL and those who were very dissatisfied/dissatisfied with their health was higher among those with functional and psychosocial impact of oral disorders. There was a negative correlation between the scores on the domains of QOL and the severity of the impact of the oral disorders (r-value ranged from -0.107 to -0.30).

CONCLUSION

Individuals with functional and psychosocial impact of oral disorders were found to more frequently rate their QOL as poor/very poor, and were more often dissatisfied with health. The correlation between the scores of QOL and functional and psychosocial impact of oral disorders scores was weak, indicating that they represent different constructs. The measures of functional and psychosocial impact of oral disorders should be complemented by general measures of QOL.

Oral health status and its impact on the quality of life of children and adolescents living with HIV-1

Background

Oral health problems can generate considerable negative effects on the quality of life of individuals living with HIV. The aim of this study was investigate the oral health status and its impact on the quality of life of 1 to 18 years-old living with HIV-1 under follow-up at referral centers in Southern Brazil.

Methods

A cross-sectional study involving individuals under follow-up (n = 36) was carried out. The individuals living with HIV-1 and their guardians underwent individual interviews using validated questionnaires for assessing oral health-related quality of life according to age group. Clinical oral examinations were performed to establish oral health status, in terms of caries and treatment need, HIV-1-related gingival as well as stomatological changes. Medical records were reviewed searching for clinical history of the infection and the presence of HIV-1-related diseases. Association studies between frequent/very frequent oral health-related impact on quality of life and independent variables were performed using Fisher’s exact test.

Results

The prevalence of frequent/very frequent oral health-related impact on quality of life was 69.0%. The prevalence of caries was 75.9%. Gingival changes were present in 20.7% of the individuals. Dental treatment was needed in 72.4% of the patients. HIV-1-related disease was present in 55.2%. The variables significantly associated with the prevalence of frequent/very frequent impact on oral health-related quality of life were dental treatment need (p = 0.037) and being more than 12 years of age (p = 0.041).

Conclusions

Individuals living with HIV-1 with need for dental treatment and those over 12-years of age reported a statistically higher frequency of frequent/very frequent oral health-related impact on quality of life.

Oral health associated with quality of life of people living with HIV/AIDS in Brazil

Background

The epidemic of HIV/AIDS enters into its fourth decade and is still considered an important public health problem in developed and developing countries. The purpose is verify the oral health and other factors that influence the quality of life of people living with HIV/AIDS attending a public service reference in Brazil.

Methods

The participants answered the questionnaire on socio-demographic conditions, issues related to HIV and daily habits. The quality of life was analyzed by the HIV/AIDS Targeted Quality of Life (HAT-QoL) instrument with 42 items divided into nine domains: General Activity, Sexual Activity, Confidentiality concerns, Health Concerns, Financial Concern, HIV Awareness, Satisfaction with Life Issues related to medication and Trust in the physician. The oral health data were collected by means of the DMFT index, use and need of dentures and the Community Periodontal Index, according to the criteria proposed by the World Health Organization, by a calibrated researcher. Bivariate and multiple linear regressions were performed.

Results

Of the participants, 53.1% were women and had a mean age of 42 years, 53.1% had eight years or less of schooling and 20.3% were not employed. In analyzing the quality of life domain of the HAT-QoL, with a lower average there was: Financial concern (39.4), followed by Confidentiality concern (43.2), Sexual activities (55.2) and Health concerns (62. 88). There was an association between the variables: do not have link to employment (p <0.001), is brown or black (p = 0.045), alcohol consumption (p = 0.041), did not make use of antiretroviral therapy (p = 0.006), high levels of viral load (p = 0.035) and need for dentures (p = 0.025), with the worse quality of life scores.

Conclusion

Socioeconomic and inadequate health conditions had a negative impact on the quality of life of people with HIV/AIDS.

Aspectos demográficos e manifestações clínicas bucais de pacientes soropositivos para o HIV/Aids

INTRODUÇÃO: As lesões bucais e peribucais são comuns nos pacientes infectados pelo vírus HIV e podem representar os primeiros sinais da doença, antes mesmo das manifestações sistêmicas. OBJETIVO: Este estudo objetivou estimar a prevalência de manifestações bucais em indivíduos soropositivos para o HIV, considerando aspectos sociodemográficos, imunológicos e terapêuticos. MATERIAL E MÉTODO: Foi realizado um estudo de natureza clínico-epidemiológica transversal, entre outubro de 2007 e abril de 2008, com amostra composta por 40 pacientes. Utilizou-se a técnica de observação direta intensiva por meio de exame clínico apropriado. Os dados foram registrados em fichas pré-elaboradas e analisados por estatística descritiva e inferencial. RESULTADO: Verificou-se a prevalência do gênero feminino (52,5%), na faixa etária de 40 a 49 anos (45%). O tratamento com antirretrovirais foi constatado em 85,0% dos casos, sendo todos com terapia de alta potência (HAART). Observou-se que 52,5% dos pacientes apresentaram a contagem de linfócitos TCD4+ acima de 500cél/mm³ e 50,0% apresentaram carga viral indetectável. A prevalência das manifestações bucais foi 42,5%, sendo a mais expressiva a candidose pseudomembranosa (19,23%), seguida da periodontite úlcero-necrosante (15,38%), da leucoplasia pilosa (11,54%) e da queilite angular (11,54%). Não foi verificada associação entre manifestações bucais e carga viral (p=0,1268), nem com o número de células T CD4 (p=0,3458). CONCLUSÃO: A prevalência de algumas manifestações bucais associadas à infecção pelo HIV ainda é alta, sendo a candidose pseudomembranosa a infecção mais prevalente, principalmente entre pessoas com baixo nível de escolaridade e maior tempo de infecção pelo vírus HIV, independentemente da terapia utilizada e do estado imunológico do paciente.