Risk factors for oral hairy leukoplakia in HIV‐infected adults of Brazil

Moura, Mariela Dutra Gontijo; Grossmann, Soraya de Mattos Camargo; Fonseca, Linaena Méricy da Silva; Senna, Maria Inês Barreiros; Mesquita, Ricardo Alves

doi:10.1111/j.1600-0714.2006.00428.x

Cited by 20 publications

(24 citation statements)

References 41 publications

(102 reference statements)

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“…This was in contrast to other studies where OHL was associated to high HIV viral load [9, 24, 30]. Patton et al found that patients with OHL were twofold more likely to have a higher viral load than people without oral lesions [30], whereas Moura et al had suggested OHL as a clinical marker for HIV viral load >3000 copies/ μ L [31]. Our finding of negative correlation for OHL should be explored in future studies whether there is any difference in relationship between OHL and high viral loads in developing and developed nations.…”

Section: Discussionmentioning

confidence: 75%

Prevalence of Oral Manifestations and Their Association with CD4/CD8 Ratio and HIV Viral Load in South India

Sharma¹,

Keerthilatha

Nagpal

2011

International Journal of Dentistry

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The objective of the present research was to determine the prevalence of oral manifestations in an HIV infected population from south India and evaluate their association with HIV viral load and CD4/CD8 ratio. Intraoral examination of 103 patients, whose CD4/CD8 ratio was available, were conducted. HIV viral loads were available for thirty patients only. The prevalence of oral manifestations was 80.6% (83/103). The most common oromucosal lesion was erythematous candidiasis (EC) (38.8%) followed by melanotic hyperpigmentation (35.9%). Patients having any oral manifestation had a mean CD4/CD8 ratio of 0.24. EC had positive predictive value of 85.0% for CD4/CD8 ratio <0.30. The prevalence of oral manifestations in patients taking ART was lesser (78.6%) as compared to patients not taking ART (82%). Patients having any oral manifestation had a higher HIV viral load as compared to patients not having any oral manifestations (P < 0.05). Pseudomembranous candidiasis (PC) was significantly associated with higher HIV viral loads (>20,000 copies/mL) (P < 0.05). Patients having EC had 4 times greater chance of having CD4/CD8 ratio <0.30. PC can be considered as a marker of immune suppression (HIV viral load >20,000 copies/mL).

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Section: Discussionmentioning

confidence: 75%

Prevalence of Oral Manifestations and Their Association with CD4/CD8 Ratio and HIV Viral Load in South India

Sharma¹,

Keerthilatha

Nagpal

2011

International Journal of Dentistry

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“…Likewise, the HL cases occurred at viral loads far below the ones related with the risk of opportunistic HL. 10 The only event not occurring above 200 CD4þ T-cells/mL was the oral KS case, but showed a rapid deterioration pattern that is consistent with IRIS, 11 and certainly not expected as opportunistic in people with such a good response to treatment and a good CD4þ T-cell recovery. We thus consider the finding of this KS IRIS as a control validating the capacity of our methodology.…”

Section: Discussionmentioning

confidence: 80%

Identification of oral candidosis, hairy leukoplakia and recurrent oral ulcers as distinct cases of immune reconstitution inflammatory syndrome

Ramírez‐Amador

Espinosa²,

González-Ramírez

et al. 2009

Int J STD AIDS

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Oral lesions such as candidosis, hairy leukoplakia (HL) and oral ulcers are strikingly absent in the numerous reports of immune reconstitution inflammatory syndrome (IRIS). To document oral manifestations attributable to immune reconstitution, we conducted a longitudinal follow-up of a cohort of HIV+ individuals starting highly active antiretroviral therapy (HAART) and completing oral pathology follow-up up to 12 weeks after treatment initiation. HIV-infected patients had oral examinations, CD4+ T-cell count and viral load determinations performed at baseline, and at weeks 4, 8 and 12 after HAART initiation. Among individuals with satisfactory viral response and recovery of > or =50 CD4+ T-cell/microL, eight patients complied with strict IRIS criteria: two developed clinical signs of oral candidosis (OC), two oral ulcers, three HL and one Kaposi's sarcoma. CD4+ T-cell counts at symptom onset suggested no remaining immune suppression. Our findings show that cases of OC, HL and recurrent ulcers can be instances of IRIS.

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“…However, risk indicators described in the literature are variable according to studied population. Risk indicators for OHL in Brazilian HIVinfected adults were viral load, OC, and use of fl uconazole or acyclovir, while antiretroviral drugs were shown to be protective for OHL (Moura et al, 2006 ). CD4 count and antiretroviral drug were relevant risk indicators for OC and OHL in HIV-infected adults of North Carolina, but smoking was an important risk indicator just for OC (Chattopadhyay et al, 2005b ).…”

Section: Ohl Classifi Cation Etiology and Risk Indicatorsmentioning

confidence: 98%

“…They have been accepted as markers of immunosuppression (Miziara and Weber 2006 ;Reginald and Sivapathasundharam 2010 ;Patton et al, 2013 ), contributing for the early identifi cation of HIV infection or AIDS (Dias et al, 2012 ). In addition, OHL and OC can be a sign to warn dentists on the decreasing immunological condition of HIVinfected patients (Moura et al, 2006 ;Sontakke et al, 2011 ;Bodhade et al, 2011 ). Although OC appears to be a superior indicator of immune decline and virologic levels in individuals submit to highly active antiretroviral therapy (HAART), the presence of OHL and OC simultaneously has also been observed as an indicator of low CD4 count and high viral load (Miziara and Weber 2006 ).…”

Section: Oral Candidiasis Oral Hairy Leukoplakia and Hiv Infectionmentioning

confidence: 99%

Oral Hairy Leukoplakia

et al. 2015

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Oral hairy leukoplakia (OHL) and oral candidiasis (OC) are the most common Human Immunodefi ciency Virus (HIV) infection-associated oral diseases, and can act as a marker for immunosuppression. Patients with a prolonged immunodefi ciency caused by HIV infection tend to develop OHL and OC, as a progression of Acquired Immune Defi ciency Syndrome (AIDS). Few studies describe the joint manifestation of OHL and OC, and its fi ndings are enigmatic. Lower CD4 count and smoking in HIV-infected patients can be independent risk factors for joint manifestation of OHL and OC. OC can be a primary disease or a secondary lesion superimposed on OHL. OHL is a benign oral lesion related to the infection of oral epithelium by Epstein-Barr virus (EBV). It is commonly related with AIDS, but it may also be observed in patients with other immunosuppressed states. OHL is an asymptomatic white plaque on the lateral borders of the tongue and a fl at, corrugated, or hairy surface that is not removable when scraped. EBV can be identifi ed through electronic microscopy techniques, in situ hybridization, immunohistochemistry, and polymerase chain reaction; however, the exfoliative cytology can also be used to diagnose OHL. Treatment for OHL is not necessary in most of the patients. Topical treatment such as

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Risk factors for oral hairy leukoplakia in HIV‐infected adults of Brazil

Abstract: Prevalence of OHL was 28.8%. Viral load, oral candidiasis, previous use of fluconazole, and systemic acyclovir were determined to be risk factors for OHL. Antiretroviral medication proved to be protective against the development of OHL.

Cited by 20 publications

References 41 publications

Prevalence of Oral Manifestations and Their Association with CD4/CD8 Ratio and HIV Viral Load in South India

Prevalence of Oral Manifestations and Their Association with CD4/CD8 Ratio and HIV Viral Load in South India

Identification of oral candidosis, hairy leukoplakia and recurrent oral ulcers as distinct cases of immune reconstitution inflammatory syndrome

Oral Hairy Leukoplakia

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