Oral Lesions of HIV Disease and HAART in Industrialized Countries

Abstract

The epidemiology of HIV-related oral disease in industrialized nations has evolved following the initial manifestations described in 1982. Studies from both the Americas and Europe report a decreased frequency of HIV-related oral manifestations of 10-50% following the introduction of HAART (highly active antiretroviral therapy). Evidence suggests that HAART plays an important role in controlling the occurrence of oral candidosis. The effect of HAART on reducing the incidence of oral lesions, other than oral candidosis, does not appear as significant, possibly as a result of low lesion prevalence in industrialized countries. In contrast to other oral manifestations of HIV, an increased prevalence of oral warts in patients on HAART has been reported from the USA and the UK. HIV-related salivary gland disease may show a trend of rising prevalence in the USA and Europe. The re-emergence of HIV-related oral disease may be indicative of failing therapy. A range of orofacial iatrogenic consequences of HAART has been reported, and it is often difficult to distinguish between true HIV-related oral disease manifestations and the adverse effects of HAART. A possible association between an increased risk of oral squamous cell carcinoma and HIV infection has been suggested by at least three epidemiological studies, with reference to the lip and tongue. These substantial and intensive research efforts directed toward enhancing knowledge regarding the orofacial consequences of HIV infection in the industrialized nations require dissemination in the wider health care environment.

The oral microbiome in human immunodeficiency virus (HIV)-positive individuals

“…(candidiasis) and by viruses such as herpes simplex virus, varicella-zoster virus, Epstein-Barr virus and human papilloma viruses (Reznik, 2005). Oral candidiasis is a particularly common problem in HIV-infected individuals, although the introduction of HAART has led to a decline in its incidence (Hodgson et al, 2006). Infection with HIV is also associated with the periodontal diseases: linear gingival erythema, nectrotizing ulcerative gingivitis (NUG) and acute necrotizing periodontitis (ANP) (Mataftsi et al, 2011).…”

Perfil epidemiológico oral y necesidad de tratamiento odontológico de pacientes VIH/SIDA

“…Estos resultados podrán indicar la posible relación entre la presencia de esta patología infecciosa y el estado de salud oral de los que la padecen. Se ha afirmado que el estado de salud oral de este tipo de pacientes podría considerarse además un factor de riesgo para su bienestar 17 .…”

“…Las diferencias en la prevalencias observadas pueden estar en relación con las diferentes características y particularidades de cada población estudiada, con el contexto sociocultural en el que se desarrollaron las investigaciones y, posiblemente, con los criterios de selección de cada estudio. Además, el tipo de clasificación de manifestaciones orales utilizado constituye un factor determinante para obtener la prevalencia de la misma, aunque en la actualidad se ha observado una tendencia a disminuir, debido a la aplicación de terapia antirretroviral altamente activa 17,19 .…”

Oral Lesions: Poor Markers of Virologic Failure in HIV-Infected Patients on Antiretroviral Therapy

“…Oral manifestations of patients with HIV infection have been considered to be of particular value in this regard [1][2][3]. Moreover, persistent candidiasis and hairy leukoplakia, in particular, are strongly associated with immunologic failure and progression of HIV disease [4,5].…”