Correlation of Oral Hairy Leukoplakia, HAART and CD4+ in HIV-infected pediatric patients at UPIPI Soetomo Hospital Surabaya, Indonesia

Indonesian pediatric population infected with Human Immunodeficiency Virus (HIV) has increased drastically in recent years. The number of new infection among infants and children (< 4 years) multiplied in 2010-2016. However, since healthcare and laboratory facilities are scare to many areas in the country, many children living with HIV are still left undiagnosed and unaware of their status. Oral Hairy Leukoplakia (OHL) as HIV-associated oral manifestation can be a useful marker in making presumptive diagnosis and prediction of the course of HIV. However, Indonesian study on OHL in pediatric HIV-infected population is still lacking, thus the study aim was to evaluate the correlation of OHL based on the use of Highly Active Antiretroviral Therapy (HAART) and immunosuppression degree among HIV-infected Indonesian pediatric patient. HIV-infected pediatric patients attending the outpatient clinic, Intermediate Care and Infectious Disease Centre (UPIPI), Dr. Soetomo Hospital between June-October 2017 were examined intraorally for the presence of OHL. Other relevant data were collected from interview to parents/guardians and patients' medical records for further analysis. Four (14.29%) patients showed to have OHL at examination and were severely immunosuppressed (mean CD4 counts= 74cells/mm ³ ). Statistical analysis using chi-square test confirms a significant correlation between OHL and HAART (P=0.027 P < 0.05). Correlation between OHL and degree of immunosuppression have very significant correlation (P =0.003 P < 0.01). The presence of OHL may indicate a high probability that infected children are in declining CD4+ counts to AIDS or experiencing treatment failure. Through immediate follow up, mortality can be prevented.