RELATIONSHIP BETWEEN CD4+ COUNT, SERUM INFLAMMATORY CYTOKINES AND ORAL MELANOTIC HYPERPIGMENTATION IN NEWLY DIAGNOSED HIV SEROPOSITIVE PATIENTS- A NESTED CASE CONTROL STUDY

Abstract Background: Oral Melanotic hyperpigmentation in HIV patients 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. Methodology The study was conducted among newly diagnosed HIV seropositive patients at the Infectious Disease Clinic, Ibadan, Nigeria. The cases were patients with OMH being matched for age and sex with controls, those without OMH. CD4+ count and cytokine levels (IL-6 and TNF-α) were compared between the cases and controls. SPSS version 21 was used for data analysis. Results Seventy newly diagnosed HIV sero- positive patients were studied, which comprised of 35 cases and 35 controls respectively. The median CD4+ counts for cases and controls were 174 cells/mm3 (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 among the cases compared to the control group (p= 0.019). Serum cytokine levels did not significantly vary between the cases and controls. Conclusion There was a significant association between HIV-OMH and severe immunosuppression in the newly diagnosed HIV seropositive patients.