Human immunodeficiency virus (HIV) infection has been associated with a large number of oral conditions.
Although antiretroviral treatment has significantly reduced the incidence of these conditions, they are still a significant problem for HIV-positive patients.
In this article, we discuss some of the most common oral manifestations of HIV infection.
Oral candidiasis is one of the most common oral conditions among HIV-positive patients.
It is caused by a fungus called Candida albicans, which normally grows in the mouth of healthy people, but can overgrow in people with weakened immune systems.
Oral candidiasis manifests itself in white, cream or yellow spots on the tongue, lips or inside the mouth, which can be painful and bleed easily when scratched.
Oral herpes is also a common condition among HIV-positive patients.
Manifestations are painful, swollen blisters that appear in clusters on the lips, tongue or inside the mouth. These can be very painful and cause difficulty eating or drinking.
Although oral herpes can be treated with antiviral drugs, it can become recurrent in people with weakened immune systems.
Leukoplakia is another oral condition that can occur in HIV-positive patients.
It manifests as white or grey patches on the inside of the mouth, which can be painful and bleed easily when scratched. Leukoplakia may be a pre-cancerous condition and requires immediate medical evaluation.
Gingivitis and periodontitis are inflammatory conditions of the gums and supporting tissues of the teeth, which may be more common in HIV-positive patients.
These conditions can cause bleeding gums, pain and tooth loss. Regular dental care and prompt treatment of gingivitis and periodontitis can prevent the progression of these conditions and help maintain oral health.
Oral candidiasis or oral mycosis is another common condition in HIV-positive patients.
It is caused by a fungal infection and is manifested by the appearance of white or yellow spots on the inside of the mouth, which can be painful and cause a burning sensation.
Oral candidiasis can be treated with antifungal drugs.
It is important that HIV-positive patients pay particular attention to oral hygiene and make regular visits to the dentist.
It is also important to discuss your medical history with your doctor and inform them of any oral conditions or symptoms you are experiencing.
With proper care and open communication with the medical team, HIV-positive patients can maintain oral health and prevent associated complications.
Inoculation of the HIV retrovirus into the body results in a chronic, irreversible infection in which the host’s defence mechanisms are progressively destroyed and acquired immunodeficiency syndrome sets in.
HIV infection does not produce immediate and specific reactions.
The whole process takes years and affects the functioning of several organs.
The final stage of HIV infection results in AIDS. This lowers the body’s general immunity, creating an environment conducive to opportunistic infections.
The systems and organs that may suffer from decreased immunity are the nervous, respiratory, cardiovascular and circulatory systems, the skin and mucous membranes will suffer various lesions and the organs may develop malignant tumors, which will have an increased risk of unfavorable outcome.
HIV infection can be transmitted through the following routes:
Blood transfusions – by introducing contaminated blood into the body. Patients with chronic kidney failure who are on dialysis are at greater risk.
Perinatal – from infected mother to fetus.
Exposure to infected blood – the virus, found in infected material, can be inoculated into the body through lesions on the skin.
First contact with the virus is asymptomatic in more than half of cases.
However, if infection does occur, it can take the form of infectious mononucleosis, meningitis, neuritis or acute encephalitis. The disease may remain latent for the first 3-5 years.
Then, in most cases, the course is vertical, rapid, destructive.
In the oral cavity, HIV manifests itself as follows:
Angular cheilitis – occurs in the early stages of HIV infection; clinically, cracks appear at the oral commissures which are painful and scabs form in the healing process. Angular cheilitis limits the opening of the mouth. Saliva production is also decreased, leading to mucosal dehydration. Treatment consists of topical application of antifungal substances 4 times a day.
Candidiasis – is characterized by the presence of multiple, white, bluish-white or yellow, small plaques located on a normally colored mucosa. They can be easily removed by wiping, leaving a red, bleeding area.
Hairy leukoplakia – is caused by the Epstein-Barr virus, responsible for the onset of infectious mononucleosis. Affects the lateral margins of the tongue, usually bilaterally; characterized by the presence of multiple, vertical, white, hyper keratinized filaments. Lesions cannot be removed by scraping.
Herpes – is triggered by the presence of herpes simplex viscus. It is characterized by translucent vesicles with serous or bloody contents. Primary infection occurs in childhood. In adults, those who develop recurrent herpes are only those who have a depressed immune system. The adhering gums are swollen and painful. It greatly hinders speech and chewing processes. The appearance of vesicles is accompanied by altered general condition, fever and fatigue.
Mouth ulcers – are circumscribed, white ulcers surrounded by a red halo. They can occur due to a decrease in the body’s immunity, but also in relation to mechanical agents that cause minor trauma to the oral mucosa.
Necrotizing stomatitis – is a localized, very rapidly destructive condition of the alveolar bone and overlying gingiva. It starts with intense pain. The gum becomes flaky and portions of it necrotic.
These manifestations are associated with AIDS in the oral cavity. Their treatment is localized, symptomatic and improvement of oral health does not mean cure and elimination of HIV from the body.
The conclusion is that HIV positive patients are more likely to develop oral conditions such as oral herpes, leukoplakia, gingivitis and periodontitis, oral candidiasis and others.
These conditions can be painful and can lead to problems with eating and hydration.
It is important that HIV-positive patients pay particular attention to oral hygiene and make regular visits to the dentist. With proper care and open communication with the medical team, HIV-positive patients can maintain oral health and prevent associated complications.