Oral Manifestations of HIV/AIDS in Patients on Antiretroviral Therapy: A 5-Year Retrospective Study in East Africa

Abstract

The advent of antiretroviral therapy (ART) has fundamentally transformed the clinical presentation and progression of HIV/AIDS, particularly regarding oral manifestations that have historically served as early indicators of immune suppression. This retrospective study examines the prevalence, distribution, and clinical characteristics of oral lesions in HIV-positive patients receiving ART across multiple healthcare facilities in East Africa over a five-year period from 2018 to 2023. A comprehensive review of 2,847 patient records revealed significant shifts in the epidemiological patterns of oral manifestations, with traditional opportunistic infections showing marked decline while non-infectious conditions demonstrated relative increases. The study documented oral candidiasis in 18.3% of patients, oral hairy leukoplakia in 7.2%, Kaposi's sarcoma in 4.1%, and necrotizing periodontal diseases in 11.8% of the cohort. Statistical analysis revealed strong correlations between CD4+ T-cell counts below 200 cells/μL and increased prevalence of opportunistic oral infections, while patients maintaining CD4+ counts above 500 cells/μL demonstrated significantly reduced occurrence of AIDS-defining oral lesions. The findings underscore the continuing importance of oral health surveillance in comprehensive HIV care, despite improvements in systemic disease management through ART. This study contributes valuable data to the limited body of research on oral HIV manifestations in resource-limited settings and provides evidence-based recommendations for integrating oral health assessment into routine HIV care protocols in East African healthcare systems.