Oral Lesions in HIV Sero positive pediatric patients and isolation and speciation of Oral Candida

A total of 150 HIV seropositive pediatric patients were screened for oral and systemic lesions. Candidal samples were collected for 122 patients using swab technique and CFU was estimated. Candidal species were isolated by using CHROMagar. · Out of 150 patients, 82 (55.7%) were males and 68 (45.3%) were females and majority of them were between the age group of 6-12 years. · 139 patients (92.7%) had full term birth status and about 9(6%) patients had history of premature birth status and for the rest of the patients birth status was not known. · The most common route of transmission in our study was vertical transmission which was seen in 143 patients (95.3%) and only 6 (4%) patients acquired HIV infection through blood transmission. · 54% of patients were breast fed while bottle feeding was seen in 8% of patient and rest of the patients had combination of both. · The most common systemic lesion observed in our study was lymphadenopathy followed by tuberculosis, pulmonary tuberculosis was seen in 21.3% and extra pulmonary tuberculosis was seen in 45.4% of cases. The latter manifested in the form of Cold abscess. · Measles, otititis media, mumps and parotid gland enlargement were the other systemic infections observed in our study group. Oral pharyngeal candidiais and Systemic candidiasis was observed in 4 (2.7%) patients. · The common skin lesions seen in our study were scabies, impetigo, herpetic eruption, perioral wart and molluscum contagiosum. · All the 150 HIV infected children had at least one systemic and oral lesion at the time of examination. · The common oral lesion observed was Oral candidiasis of which PC was the most predominant, followed by AC, EC, HC and combination of PC and EC. · Conventional gingivitis, pigmentation, depapillation of tongue, oral hairy leucoplakia, oral ulcer patients and Kaposi’s sarcoma were other oral lesions observed in our study. · Samples for candida were collected from 36 asymptomatic and 86 symptomatic patients by using swab technique · CHROMagar was used to identify the candial species. C.albicans was the common species isolated from both symptomatic and asymptomatic patients. The prevelance of Candida species is more in symptomatic patients than the asymptomatic patients which was statistical significant. · C.tropicalis, mixed type of colonies of C.albicans with C.krusei and C.tropicalis and non-specific species with C.albicans and C.tropicalis were also identified. · CFU count was calculated using Samarnayaka technique. The mean CFU was increased in symptomatic than in asymptomatic patients and was statistical significant. In conclusion, all the children in this study presented with at least one oral lesion. We state that systemic and oral mucosal lesions are a feature of HIV infection in the pediatric population. Furthermore, additional studies investigating the association between oral lesion and CD4 counts in a large sample size would be beneficial for developing prognostic markers for HIV infected children in our country