Oral cytology in human immunodeficiency virus (HIV): An immune marker?

Low CD4 counts is currently considered to be one of the main indicators of the progression of human immunodeficiency virus (HIV)-induced immune depression, but few studies have analyzed its relationship to the presence of oral cytological changes. The aim of this cross sectional study was to analyze the relationship between total CD4 lymphocyte count and the occurrence of cytological changes. The present cross-sectional study included 40 HIV infected patients seen at a clinic for sexually transmitted diseases and HIV. Oral smears were obtained from dorsum of the tongue and the buccal mucosa using tongue blade and smear was transferred on a glass slide and fixed. The samples were assessed for the presence or absence of cytological changes, and correlated it with their CD4 counts. The CD4 lymphocyte counts of each of the 40 cases was noted and categorized as those below 500 cells/mm3 and above 500 cells/mm3. A total of 24 cases showed CD4 counts less than 500 cells. It was observed that the lesser the CD4 lymphocyte count, the greater the cell yield. These findings suggest that oral cytological changes could be a useful clinical marker of patients with HIV and can also be used as an adjuvant to CD4 counts. In view of these results, emphasis should be placed on the importance of thorough examination of the oral cavity and obtaining oral smears, as these changes provides indirect information about the patient’s immune state.