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Oral Manifestations of Human Immunodeficiency Virus Infection: Early Diagnostic Indicators

  • Hee-Won Kim (Department of Oral Medicine, Dental Research Institute, Pusan National University Dental Hospital) ;
  • Yong-Woo Ahn (Department of Oral Medicine, Dental Research Institute, Pusan National University Dental Hospital) ;
  • Sung-Hee Jeong (Department of Oral Medicine, Dental Research Institute, Pusan National University Dental Hospital) ;
  • Soo-Min Ok (Department of Oral Medicine, Dental Research Institute, Pusan National University Dental Hospital) ;
  • Hye-Min Ju (Department of Oral Medicine, Dental Research Institute, Pusan National University Dental Hospital)
  • Received : 2024.08.30
  • Accepted : 2024.09.07
  • Published : 2024.09.30

Abstract

This paper highlights the importance of oral manifestations as indicators for early human immunodeficiency virus (HIV) detection through two case studies. HIV, responsible for acquired immunodeficiency syndrome (AIDS), damages CD4+ T-lymphocytes, leading to severe immunosuppression and increased vulnerability to various infections. Oral lesions often appear early in HIV infection and can signal disease progression. The study underscores the role of dentists in identifying these lesions, which can serve as crucial markers for HIV. We used two cases to illustrate the importance of screening in HIV patients. The first was a patient presented with oral soreness and a mass on his tongue. Despite having a positive HIV test result in a previous medical examination, but patient had intentionally concealed his infection. The second was a patient experienced dry mouth and burning sensation, with symptoms unresponsive to repeated antifungal treatments and suspected esophageal fungal infection. This led to the discovery of an HIV-positive status in a patient previously unaware of his infection. In both cases, oral manifestations played a crucial role in the early diagnosis of HIV/AIDS. These manifestations can be particularly useful for identifying HIV in patients who are asymptomatic or unaware of their status. Although oral lesions, such as oral candidiasis and oral hairy leukoplakia, are not exclusive to HIV but are more prevalent and severe in HIV-positive individuals. The findings support routine HIV screening and the critical role of dentists in recognizing oral signs of HIV infection to facilitate early diagnosis and treatment.

Keywords

Acknowledgement

This study was supported by Clinical Research Grant, Pusan National University Dental Hospital (2024).

References

  1. Glick M, Muzyka BC, Lurie D, Salkin LM. Oral manifestations associated with HIV-related disease as markers for immune suppression and AIDS. Oral Surg Oral Med Oral Pathol 1994;77:344-349.  https://doi.org/10.1016/0030-4220(94)90195-3
  2. Lomeli-Martinez SM, Gonzalez-Hernandez LA, Ruiz-Anaya AJ, et al. Oral manifestations associated with HIV/AIDS patients. Medicina (Kaunas) 2022;58:1214. 
  3. Tappuni AR. The global changing pattern of the oral manifestations of HIV. Oral Dis 2020;26(Suppl 1):22-27.  https://doi.org/10.1111/odi.13469
  4. Vohra P, Jamatia K, Subhada B, Tiwari RVC, Althaf MN, Jain C. Correlation of CD4 counts with oral and systemic manifestations in HIV patients. J Family Med Prim Care 2019;8:3247-3252.  https://doi.org/10.4103/jfmpc.jfmpc_767_19
  5. United Nations Programme on HIV/AIDS (UNAIDS). Global HIV & AIDS statistics - fact sheet [Internet]. UNAIDS; c2024 [cited 2024 Aug 2]. Available from: https://www.unaids.org/en/resources/fact-sheet. 
  6. Korea Disease Control and Prevention Agency (KDCA). 2023 Annual report on the notified HIV/AIDS in Korea [Internet]. KDCA; c2024 [cited 2024 Jun 26]. Available from: https://dportal.kdca.go.kr/pot/bbs/BD_selectBbs.do?q_bbsSn=1010&q_clsfNo=1&q_bbsDocNo=20240626130405843&q_currPage=1. 
  7. Coogan MM, Greenspan J, Challacombe SJ. Oral lesions in infection with human immunodeficiency virus. Bull World Health Organ 2005;83:700-706. 
  8. Patton LL, van der Horst C. Oral infections and other manifestations of HIV disease. Infect Dis Clin North Am 1999;13:879-900.  https://doi.org/10.1016/S0891-5520(05)70114-8
  9. Indrastiti RK, Wardhany II, Soegyanto AI. Oral manifestations of HIV: can they be an indicator of disease severity? (A systematic review). Oral Dis 2020;26(Suppl 1):133-136.  https://doi.org/10.1111/odi.13394
  10. Kim YH, Lee JH. The relationship of quality of health-related life with the status of oral health in adults. J Korean Acad Oral Health 2016;40:165-170.  https://doi.org/10.11149/jkaoh.2016.40.3.165
  11. Askinyte D, Matulionyte R, Rimkevicius A. Oral manifestations of HIV disease: a review. Stomatologija 2015;17:21-28. 
  12. Khoury ZH, Meeks V. The influence of antiretroviral therapy on HIV-related oral manifestations. J Natl Med Assoc 2021;113:449-456. 
  13. Anwar KP, Malik A, Subhan KH. Profile of candidiasis in HIV infected patients. Iran J Microbiol 2012;4:204-209. 
  14. Spalanzani RN, Mattos K, Marques LI, et al. Clinical and laboratorial features of oral candidiasis in HIV-positive patients. Rev Soc Bras Med Trop 2018;51:352-356.  https://doi.org/10.1590/0037-8682-0241-2017
  15. Vila T, Sultan AS, Montelongo-Jauregui D, Jabra-Rizk MA. Oral candidiasis: a disease of opportunity. J Fungi (Basel) 2020;6:15. 
  16. Suryana K, Suharsono H, Antara IGPJ. Factors associated with oral candidiasis in people living with HIV/AIDS: a case control study. HIV AIDS (Auckl) 2020;12:33-39. 
  17. Egusa H, Soysa NS, Ellepola AN, Yatani H, Samaranayake LP. Oral candidosis in HIV-infected patients. Curr HIV Res 2008;6:485-499.  https://doi.org/10.2174/157016208786501445
  18. Triantos D, Porter SR, Scully C, Teo CG. Oral hairy leukoplakia: clinicopathologic features, pathogenesis, diagnosis, and clinical significance. Clin Infect Dis 1997;25:1392-1396.  https://doi.org/10.1086/516131
  19. Piperi E, Omlie J, Koutlas IG, Pambuccian S. Oral hairy leukoplakia in HIV-negative patients: report of 10 cases. Int J Surg Pathol 2010;18:177-183.  https://doi.org/10.1177/1066896908327865
  20. Broder S. The development of antiretroviral therapy and its impact on the HIV-1/AIDS pandemic. Antiviral Res 2010;85:1-18. https://doi.org/10.1016/j.antiviral.2009.10.002