Oral Manifestations after Immune Reconstitution in HIV Patients on Haart

Abstract

In order to verify possible association between immune reconstitution inflammatory syndrome (IRIS) and oral manifestations (OMs), we selected AIDS patients who had low CD4 count before the initiation of highly active antiretroviral therapy (HAART) and who returned three months later for therapy evaluation. The oral lesions observed three months after the initiation of HAART were evaluated and associated with the type of antiretroviral therapy (ART), CD4 count and HIV-RNA load levels (before and three months after HAART initiation). A total of 105 patients matched the selected criteria. Immune reconstitution (IR) was identified in 35.2%. Among these patients, the mean CD4 cell count rose from 105.97 to 330.29 and the mean viral load dropped from 168.005 (log 5.22) to 21.852 (log 4.33). There was no significant difference in age (P = 0.78), sex (P = 0.41) or previous history of ART (P = 0.55) between IR and non-IR patients. In the IR group, the most common OM was parotid enlargement (57.14%) (P = 0.019), whereas in the non-IR group candidiasis (46.15%) was the most common OM. The results of our study suggest that the parotid gland enlargement found in the studied population might be an IRIS event, as it was found in patients with IR three months after the initiation of HAART.

The impact of Highly Active Antiretroviral Therapy (HAART) on the clinical features of HIV - related oral lesions in Nigeria

“…'An IRIS event is defined as either a first presentation or a paradoxical worsening of a pre-existing condition after the initiation of HAART in the presence of rising CD4 counts and falling HIV-1 RNA levels, if measured'[14]. The CD4 counts (cells/ml) of this patient rose from 73 to 269 while the viral load (copies/ml) dropped from 514,298 to 288.…”

Prevalence of oral mucosal lesions in adults undergoing highly active antiretroviral therapy in Hong Kong

“…HIV‐related oral mucosal lesions tend to vary among different population 13 . To our knowledge, only a few groups have studied cohorts on newer long‐term HAART, and the majority of these studies are on Caucasian populations 14–16 . Studies on other population groups in different geographic areas are warranted to obtain a true picture of the oral health needs in such groups.…”

Human Immunodeficiency Virus–Associated Lipohypertrophy (Buccal Fat Pad Lipoma-Like Lesions) Reduced with Subcutaneously Injected Sodium Deoxycholate

“…One of our initial clinical impressions of the lesions was parotid gland hyperplasia, which is prevalent in 3% to 5% of patients with HIV 27,28 . Parotid gland hyperplasia results from virally induced lymphoproliferation 29 and can be successfully treated with external beam radiation 30 .…”