Impact of Oral Lesions on Quality of Life in HIV/AIDS

Objectives: To determine the impact of oral manifestation in HIV infection on the oral health-related quality of life (OHRQoL). Methods: Participants included 175 consecutively consenting HIV-infected adults who presented at a general hospital’s outpatient HIV-clinic during the period of the study. Data was collected using a structured self-administered questionnaire containing items on sociodemographic characteristics, drug treatment status and items from an adapted instrument for measure of OHRQoL – Oral Health Impact Profile (OHIP). Oral examination was carried out on all the respondents by a trained examiner who was blinded to the completed questionnaire. The presence of HIV-related lesions and DMFT were recorded. With higher OHIP scores representing lower quality of life, the difference in the mean OHIP scores for those presenting with oral lesions and those without oral lesions was tested using Mann-Whitney U-test (p<0.05). Reliability of the instrument used was determined through Cronbach alpha estimation. Both bivariate and multivariate analyses were also carried out in order to examine construct validity. Results: Of the respondents, 61.7% (n=108) were on drug treatment and 76% (n=133) presented with at least one oral lesion. 62.3%(n=109) presented with multiple lesions, with the most common lesion being Pseudomembraneous Candidiasis (57.1%). Oral ulcer was present in 17.1% of the study population. The OHRQoL of those presenting with oral manifestations was significantly lower than for those without oral manifestation (Mean OHIP score of 32.3 Vs 23.3; p<0.05). Presenting with multiple lesions and being female were significant predictors of lower OHRQoL. The internal reliability for the OHIP used to measure OHRQoL was high, with a Cronbach alpha value of 0.92. Conclusions: Oral manifestation in HIV significantly reduces quality of life, thus the need for appropriate service planning to manage oral lesions in HIV. The OHIP used, is a reliable measure of quality of life of individuals living with HIV.