Comparison of the Prevalence In 2002 and 2022 of Oral Lesions in Patients Living with Hiva Single-Center Retrospective Cross-Sectional Study

Abstract

Introduction - The care of patients living with human immunodeficiency virus (PLHIV) has improved in recent decades, and the incidence of infections and tumors encountered in these patients has evolved. The present study aims to describe the prevalence of oral lesions in 2002 and 2022 in the same center. Methods - Adult PLHIV followed in our department were enrolled from 1999 to 2002 (retrospectively) and from October 2021 to April 2022 (prospectively).Results - In the early 2000s, 62 PLHIV were included and 112 in 2022. The two samples were homogeneous with respect to sex, use of tobacco and drugs. Age, alcohol consumption, and access to ARV treatment increased significantly between the two periods. Overall, the disease was better controlled with more patients having a lymphocyte T CD4 level > 350/mm3 (p < 0.001) and an undetectable viral load (p < 0.001). We found 63 lesions in 62 PLHIV in the early 2000s, and 23 lesions in 22 PLHIV in 2022. Between the two periods, there was a significant decrease in immunosuppression-related lesions (p < 0.001), notably oropharyngeal candidiasis (n=46/63 vs n=2/23), but an increase in lesions with malignant potential (n=0/63 vs n=4/23).Conclusion - Fewer opportunist lesions were seen in 2022 than in 2002 but they were more worrying in terms of severity. Clinical relevance - Immunosuppression seemed to be under control with antiretroviral treatment, but other causes of immunosuppression along with age and oral cancers were still observed in those with known risk factors.

Note:
Funding declaration: None.

Conflict of Interests: Nicolas Maubert declares that he has no conflict of interest. Victoire Pinet declares that she has no conflict of interest. Céline Lambert declares that she has no conflict of interest. Émilie Goncalves declares that she has no conflict of interest. Christine Jacomet declares that she has no conflict of interest. Laurent Devoize declares that he has no conflict of interest.

Ethical Approval: The data collection from 1999 to 2002 (single-center, retrospective, cross sectional study) was approved by local Ethics Committee under number 2024-CF-267 (IRB00013412, “CHU de Clermont Ferrand IRB #1”). The data collected from October 2021 to April 2022 (single-center, prospective, cross-sectional study) are in accordance with the reference methodology MR003. Its protocol and the information letter were reviewed and approved by the CPP Sud-Ouest et Outre-Mer on 04/10/2021 (RCB ID no.: 2021-A01831-40 – CPP 1-21-087 / 21.02369. 000034) and the sponsor, Clermont-Ferrand University Hospital, notified the National Agency for the Safety of Medicines and Health Products.

Keywords: PLHIV, oral mucosa