Study On The Relationship Among Oral Manifestations, Candidal Carriage And CD4~+T Lymphocyte Count And CD4~+/CD8~+ Ratio In HIV/AIDS Patients

Objective:The aim of this study was to investigate the oral health status of HIV-infected and AIDS patients, to explore the relationship among the load of candida albican, CD4+T lymphocyte count and CD4+/CD8+ ratio, and to monitor and evaluate the effect of anti-retroviral therapy (ART) on oral health which might help us to understand the oral innate immune.Methods:34 HIV-infected individuals and 36 AIDS patients diagnozed by the Center of Disease Control and Prevention of Guangxi Province were included in this study.31 healthy individuals selected by age and gender matched principle were included as health controls. Oral examinations were carried out by the standardized specialist among them, the information such as age, gender, the approach of infection, HIV/AIDS related orofacial lession were recorded in detail to evaluate the prevalence and clinical feature of HIV/AIDS oral lesions in patients. Oral rinse technique was used to detect the candida! carriage. The isolates were identified using multiple measures, including Grain staining reaction, chlamydospore, pseudohyphal and hyphal production test, CHROMagar candidal test,45℃growth test,1% Tween 80 corn agar medium test and API 20 C AUX yeast identification system. At the same time 3-4ml peripheral blood of HIV/AIDS patients were collected in order to monitor the CD4+T lymphocyte count, CD4+/CD8+ratio.Results:Among the total of 70 HIV/ATDS patients in two groups,40 patients (57.14%) complained of oral symptoms. Oral candidiosis was the most common lesion within HIV/AIDS patients. High prevalences of xerostomia.10 oral candidiosis,19 xerostomia,9 HIV related periodontitis,8 oral ulceration and 1 Herpetic stomatitis were observed. Out of 34 HIV-infected patients and 36 AIDS patients studied,34(100%)and 30(83.33%)had positive culture for Candida. The positive ratio was higher than 51.61% of healthy controls group(P<0.01). Of all Candida strains isolated from HIV/AIDS patients, the most commonly isolated Candida species were Candida albicans, Candida glabrata and Candida tropicalis.Of HIV-infected, AIDS patients and healthy controls three groups, there were no statistical difference from the positive culture rates of Candida albicans(P<0.05), but significantly(P<0.05)in the positive culture rates of Candida glabrata, Candida tropicalis. The CD4+T lymphocyte count of HIV/AIDS patients were lower than the healthy controls (P<0.05). the HIV/AIDS patients were divided into two groups with CFU<5×105CFU/L or CFU≥5×105CFU/L by the load of oral Candida. between two subgrops, CD4+T cell count was no significant difference(P>0.05). However, the CD4+/CD8+ratio of oral Candida CFU≥5×105CFU/L in patients was lower than that of CFU<5×105CFU/L(t=-3.262,P<0.01). The Spearsman rank correlation analysis indicated that the peripheral blood CD4+/CD8+ratio had a negative relation with the oral Candida CFU in 101 subjects(r=-0.293, P<0.01). CD4+T lymphocyte count(r=0.327, P<0.05), CD4+/CD8+ratio (r=0.302, P<0.05)of 36 AIDS patients had a positive correlation the ART therapy periods.Conclusions:The results indicated that the mutual relationship existed between the load of oral candida, oral characterizations, the peripheral blood CD4+ counts and CD4+/CD8+ratio. ART therapy periods of AIDS patients affect the oral healthy and oral candidal load.