Relationship between CD4+ count, serum inflammatory cytokines, and oral melanotic hyperpigmentation in newly diagnosed HIV-seropositive patients: a nested case-control study

• Published in: Oral surgery, oral medicine, oral pathology and oral radiology oral medicine, oral pathology and oral radiology, 2022-02, Vol.133 (2), p.182-188
• Main Authors: Abe, Elizabeth Oluwatoyin, Adisa, Akinyele Olumuyiwa, Adeyemi, Bukola Folasade, Awolude, Olutosin Alaba, Owotade, Foluso John
• Format: Article
• Language: English
• Subjects: Case-Control Studies; CD4 Lymphocyte Count; CD4-Positive T-Lymphocytes - pathology; Cytokines; HIV Infections - complications; HIV Infections - drug therapy; Humans; Hyperpigmentation; Nigeria
• ISSN: 2212-4403; 2212-4411
• DOI: 10.1016/j.oooo.2021.10.009

Oral melanotic hyperpigmentation (OMH) in patients with human immunodeficiency virus (HIV) infection has been attributed to the use of antifungal or antiretroviral drugs, as well as HIV-induced cytokine dysregulation. This research aimed to determine the relationship between immunosuppression and cytokine dysregulation in newly diagnosed HIV-seropositive subjects with OMH. The study was conducted among newly diagnosed HIV-seropositive patients at the Infectious Disease Clinic, Ibadan, Nigeria. The cases were patients with OMH matched for age and sex with control subjects without OMH. CD4+ count and cytokine levels (interleukin-6 and tumor necrosis factor-α) were compared between the cases and control subjects. SPSS version 21 software was used for data analysis. Seventy newly diagnosed HIV-seropositive patients were studied, which comprised of 35 cases and 35 control subjects. The median CD4+ counts for cases and control subjects were 174 cells/mm3 (interquartile range [IQR], 57-250) and 324 cells/mm3 (IQR, 107-424), respectively. Severe immunosuppression (CD4+ count, ≤200 cells/mm3) was found in over half of the study participants, being more prevalent among the cases than among the control group (P = .019). Serum cytokine levels did not significantly vary between the cases and control subjects. There was a significant association between HIV-OMH and severe immunosuppression in the newly diagnosed HIV-seropositive patients.