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Rosseto JHF, Tenório JR, Mamana AC, Tozetto-Mendoza TR, Andrade NS, Braz-Silva PH, Ortega KL. Epstein-Barr virus oral shedding and viremia and their association with oral hairy leukoplakia in HIV+ individuals. Oral Dis 2023; 29:796-802. [PMID: 34379873 DOI: 10.1111/odi.14001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 07/23/2021] [Accepted: 08/03/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To assess the oral shedding and viremia of Epstein-Barr virus (EBV) in HIV-positive patients and their relationship with oral hairy leukoplakia (OHL). METHODOLOGY A total of 94 HIV-positive patients were included in the study, in which blood and saliva samples were collected for EBV quantification. Data on gender, age, time of HIV seropositivity, combined antiretroviral therapy (cART), CD4+ T-cell counts, and HIV viral load were collected. OHL diagnosis was based on histopathological examination and EBV in situ hybridization. RESULTS The EBV load in the 94 HIV-positive patients was higher in saliva than in blood (2.4 and 1.6, respectively), and there was a positive correlation between EBV oral shedding and viremia (p = 0.001). Twenty (21.27%) patients had OHL and also a higher EBV load in saliva (mean log10 = 3.11) compared to those who had no OHL (p = 0.045). Presence of OHL was only associated with age (p = 0.030). CONCLUSION In HIV-positive patients, the presence of OHL was associated with EBV oral shedding but not with viremia, regardless of the amount of circulating CD4+ T cells.
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Affiliation(s)
| | - Jefferson Rocha Tenório
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil.,Department of Pathology and Oral Diagnosis, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Ana Carolina Mamana
- Laboratory of Virology, School of Medicine, Institute of Tropical Medicine of São Paulo, University of São Paulo, São Paulo, Brazil
| | - Tânia Regina Tozetto-Mendoza
- Laboratory of Virology, School of Medicine, Institute of Tropical Medicine of São Paulo, University of São Paulo, São Paulo, Brazil
| | - Natália Silva Andrade
- Department of Dentistry, School of Dentistry, Federal University of Sergipe, Lagarto, Brazil
| | - Paulo Henrique Braz-Silva
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil.,Laboratory of Virology, School of Medicine, Institute of Tropical Medicine of São Paulo, University of São Paulo, São Paulo, Brazil
| | - Karem L Ortega
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
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Benslama L. Oral and maxillofacial manifestations of human immunodefficiency virus infection. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2022; 123:622-633. [PMID: 35618625 DOI: 10.1016/j.jormas.2022.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 05/02/2022] [Accepted: 05/05/2022] [Indexed: 10/18/2022]
Abstract
Oral manifestations occur at all stages of human immunodeficiency virus (HIV) infection. Their clinical expressions and severity depend on the evolution of the infection and become critical at the stage of acquired immunodeficiency (AIDS). They are essentially infectious, tumoral, and, starting a few years ago, iatrogenic. Infections are mostly fungal (candidiasis), viral (herpes, zoster, human papillomavirus infections, etc.), and less frequently bacterial (streptococcemia). Cases of sexually transmitted diseases, particularly syphilis, are multiplying preoccupyingly. The most frequently observed tumors are Kaposi's sarcoma. Drug intolerance is common; the symptoms are mostly dermatological, but also oral (Stevens-Johnson syndrome and toxic epidermal necrolysis) when sulfonamides and certain antiretrovirals are used. The advent of prolonged Highly Active Anti-Retroviral Therapies (HAARTs) has led to a decline in the incidence of most opportunistic conditions, infections and tumors (except for multiple oral warts and zoster). HAARTs also provoke adverse reactions such as lipodystrophy syndromes (signs of peripheral atrophy and central hypertrophy, associated in varying degrees with metabolic syndromes). Extended survival and the new methods for prophylaxis of opportunistic infections have gradually modified diagnostic and therapeutic strategies for oral manifestations of HIV infections.
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Affiliation(s)
- L Benslama
- Department of stomatology and maxillofacial surgery, AP-HP, DHU FAST, GH Pitié- Salpêtrière- Charles Foix, Paris F-75013, France.
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Castillejos-García I, Ramírez-Amador V, Gómez-Mejía E, Badial-Hernández F, Anaya-Saavedra G. Clinical manifestations and risk factors for oral immune reconstitution inflammatory syndrome in Mexico. Oral Dis 2020; 26 Suppl 1:153-157. [PMID: 32862543 DOI: 10.1111/odi.13402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The immune reconstitution inflammatory syndrome (IRIS) is a rare acute complication presenting in people living with HIV (PLWH) within the first 6 months of starting combined antiretroviral therapy (cART). While there is relevant information about its pathogenesis and clinical spectrum, IRIS-oral lesions (IRIS-OLs) have been scarcely described. Thus, to establish the incidence and clinical characteristics of IRIS-OLs, data from a cohort of 158 HIV individuals starting cART, followed for 6 months, were obtained retrospectively. IRIS-OLs developed in 11.4% of the individuals, in a median time of 87.5 days, with oral candidiasis being the most frequent manifestation detected in eight individuals (5.1%). The study emphasizes the importance of the correct diagnosis and management of these lesions.
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Affiliation(s)
- Itzel Castillejos-García
- Oral Pathology and Medicine Master, Universidad Autónoma Metropolitana-Xochimilco, Mexico City, Mexico
| | - Velia Ramírez-Amador
- Oral Pathology and Medicine Master, Universidad Autónoma Metropolitana-Xochimilco, Mexico City, Mexico
| | - Eduardo Gómez-Mejía
- Oral Pathology and Medicine Master, Universidad Autónoma Metropolitana-Xochimilco, Mexico City, Mexico
| | | | - Gabriela Anaya-Saavedra
- Oral Pathology and Medicine Master, Universidad Autónoma Metropolitana-Xochimilco, Mexico City, Mexico
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Ramírez-Amador V, Patton LL, Naglik JR, Nittayananta W. Innovations for prevention and care of oral candidiasis in HIV-infected individuals: Are they available?-A workshop report. Oral Dis 2020; 26 Suppl 1:91-102. [PMID: 32862535 DOI: 10.1111/odi.13391] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Oral candidiasis (OC) is the most prevalent HIV-related oral lesion in patients on combined anti-retroviral therapy (cART) or without cART. Management is challenged in some patients by development of resistance to azole drugs, such as fluconazole. Recent scientific knowledge about OC pathogenesis, the role of OC in the immune reconstitution inflammatory syndrome (IRIS), the relationship of OC with the microbiome, and novelties in OC treatment was discussed in an international workshop format. Literature searches were conducted to address five questions: (a) Considering the pathogenesis of Candida spp. infection, are there any potential therapeutic targets that could be considered, mainly in HIV-infected individuals resistant to fluconazole? (b) Is oral candidiasis part of IRIS in HIV patients who receive cART? (c) Can management of the oral microbiome reduce occurrence of OC in patients with HIV infection? (d) What are the recent advances (since 2015) regarding plant-based and alternative medicines in management of OC? and (e) Is there a role for photodynamic therapy in management of OC in HIV-infected patients? A number of the key areas where further research is necessary were identified to allow a deeper insight into this oral condition that could help to understand its nature and recommend alternatives for care.
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Affiliation(s)
- Velia Ramírez-Amador
- Department of Health Care, Master´s Course in Oral Pathology and Oral Medicine, Universidad Autónoma Metropolitana-Xochimilco, México City, Mexico
| | - Lauren L Patton
- Division of Craniofacial and Surgical Care, Adams School of Dentistry University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Julian R Naglik
- Centre for Host-Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
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Speicher DJ, Ramirez-Amador V, Dittmer DP, Webster-Cyriaque J, Goodman MT, Moscicki AB. Viral infections associated with oral cancers and diseases in the context of HIV: a workshop report. Oral Dis 2016; 22 Suppl 1:181-92. [PMID: 27109286 PMCID: PMC5590239 DOI: 10.1111/odi.12418] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Revised: 09/25/2015] [Accepted: 12/09/2015] [Indexed: 12/11/2022]
Abstract
Human herpesviruses (HHVs) and human papillomavirus (HPV) are common in the general population and, in immunocompetent people, are mostly carried asymptomatically. However, once an individual becomes immunocompromised by age, illness or HIV infection these dormant viruses can manifest and produce disease. In HIV-positive patients, there is an increased risk of disease caused by HHVs and HPV infections and cancers caused by the oncoviruses Epstein-Barr Virus, HHV-8 and HPV. This workshop examined four questions regarding the viruses associated with oral cancers and disease in the HIV-positive and -negative populations, the immune response, and biomarkers useful for accurate diagnostics of these infections and their sequalae. Each presenter identified a number of key areas where further research is required.
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Affiliation(s)
- D J Speicher
- Molecular Basis of Disease Research Program, Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - V Ramirez-Amador
- Health Care Department, Universidad Autónoma Metropolitana-Xochimilco, México City, Mexico
| | - D P Dittmer
- Department of Microbiology and Immunology School of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA
| | - J Webster-Cyriaque
- Department of Microbiology and Immunology School of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA
- Department of Dental Ecology, School of Dentistry, University of North Carolina, Chapel Hill, North Carolina, USA
| | - M T Goodman
- Cancer Prevention and Control, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - A-B Moscicki
- David Geffen, School of Medicine, University of California-Los Angeles, Los Angeles, California, USA
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Burger-Calderon R, Webster-Cyriaque J. Human BK Polyomavirus-The Potential for Head and Neck Malignancy and Disease. Cancers (Basel) 2015; 7:1244-70. [PMID: 26184314 PMCID: PMC4586768 DOI: 10.3390/cancers7030835] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Revised: 06/25/2015] [Accepted: 06/25/2015] [Indexed: 12/22/2022] Open
Abstract
Members of the human Polyomaviridae family are ubiquitous and pathogenic among immune-compromised individuals. While only Merkel cell polyomavirus (MCPyV) has conclusively been linked to human cancer, all members of the polyomavirus (PyV) family encode the oncoprotein T antigen and may be potentially carcinogenic. Studies focusing on PyV pathogenesis in humans have become more abundant as the number of PyV family members and the list of associated diseases has expanded. BK polyomavirus (BKPyV) in particular has emerged as a new opportunistic pathogen among HIV positive individuals, carrying harmful implications. Increasing evidence links BKPyV to HIV-associated salivary gland disease (HIVSGD). HIVSGD is associated with elevated risk of lymphoma formation and its prevalence has increased among HIV/AIDS patients. Determining the relationship between BKPyV, disease and tumorigenesis among immunosuppressed individuals is necessary and will allow for expanding effective anti-viral treatment and prevention options in the future.
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Affiliation(s)
- Raquel Burger-Calderon
- Microbiology and Immunology Department, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
| | - Jennifer Webster-Cyriaque
- Microbiology and Immunology Department, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
- Department of Dental Ecology, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
- Lineberger Comprehensive Cancer Center, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
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Patton LL, Ramirez-Amador V, Anaya-Saavedra G, Nittayananta W, Carrozzo M, Ranganathan K. Urban legends series: oral manifestations of HIV infection. Oral Dis 2013; 19:533-50. [PMID: 23517181 DOI: 10.1111/odi.12103] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2013] [Revised: 02/27/2013] [Accepted: 03/01/2013] [Indexed: 12/13/2022]
Abstract
Human immunodeficiency virus-related oral lesions (HIV-OLs), such as oral candidiasis (OC) and oral hairy leukoplakia (OHL), have been recognized as indicators of immune suppression since the beginning of the global HIV epidemic. The diagnosis and management of HIV disease and spectrum of opportunistic infection has changed over the past 30 years as our understanding of the infection has evolved. We investigated the following controversial topics: (i) Are oral manifestations of HIV still relevant after the introduction of highly active antiretroviral therapy (HAART)? (ii) Can we nowadays still diagnose HIV infection through oral lesions? (iii) Is the actual classification of oral manifestations of HIV adequate or does it need to be reviewed and updated? (iv) Is there any novelty in the treatment of oral manifestations of HIV infection? Results from extensive literature review suggested the following: (i) While HAART has resulted in significant reductions in HIV-OLs, many are still seen in patients with HIV infection, with OC remaining the most common lesion. While the relationship between oral warts and the immune reconstitution inflammatory syndrome is less clear, the malignant potential of oral human papillomavirus infection is gaining increasing attention. (ii) Effective antiretroviral therapy has transformed HIV from a fatal illness to a chronic manageable condition and as a result expanded screening policies for HIV are being advocated both in developed and in developing countries. Affordable, reliable, and easy-to-use diagnostic techniques have been recently introduced likely restricting the importance of HIV-OLs in diagnosis. (iii) The 1993 EC-Clearinghouse classification of HIV-OLs is still globally used despite controversy on the relevance of periodontal diseases today. HIV-OL case definitions were updated in 2009 to facilitate the accuracy of HIV-OL diagnoses by non-dental healthcare workers in large-scale epidemiologic studies and clinical trials. (iv) Research over the last 6 years on novel modalities for the treatment of HIV-OLs has been reported for OC and OHL.
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Affiliation(s)
- L L Patton
- Department of Dental Ecology, School of Dentistry, University of North Carolina, Chapel Hill, NC 27599-7450, USA.
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Raboud J, Anema A, Su D, Klein MB, Zakaryan A, Swan T, Palmer A, Hosein S, Loutfy MR, Machouf N, Montaner JSG, Rourke SB, Tsoukas C, Hogg RS, Cooper C. Relationship of chronic hepatitis C infection to rates of AIDS-defining illnesses in a Canadian cohort of HIV seropositive individuals receiving highly active antiretroviral therapy. HIV CLINICAL TRIALS 2012; 13:90-102. [PMID: 22510356 DOI: 10.1310/hct1302-90] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND The influence of chronic hepatitis C virus (HCV) infection on the risk, timing, and type of AIDS-defining illnesses (ADIs) is not well described. To this end, rates of ADIs were evaluated in a Canadian cohort of HIV seropositive individuals receiving highly active antiretroviral therapy (HAART). METHODS ADIs were classified into 6 Centers for Disease Control and Prevention (CDC)-defined etiological subgroups: non-Hodgkin lymphoma, viral infection, bacterial infection, HIV-related disease, protozoal infection, and mycotic infection. Generalized estimating equation (GEE) Poisson regression models were used to estimate the effect of HCV on rates of ADIs after adjusting for covariates. RESULTS Among 2,706 HAART recipients, 768 (28%) were HCV coinfected. Rates of all ADIs combined and of bacterial infection, HIV-related disease, and mycotic infection were increased in HCV-coinfected persons and among those with CD4 counts <200 cells/mm3 HCV was associated with an increased risk of ADIs (rate ratio [RR], 1.38; 95% CI, 1.01-1.88) and a 2-fold increased risk of mycotic infections (RR, 2.21; 95% CI, 1.35-3.62) in univariate analyses and after adjusting for age, baseline viral load, baseline CD4 count, and region of Canada. However, after further adjustment for HAART interruptions, HCV was no longer associated with an increased rate of ADIs overall (RR, 1.13; 95% CI, 0.80-1.59), but remained associated with an increased rate of mycotic infections (RR, 1.97, 95% CI, 1.08-3.61). CONCLUSION Although HCV coin-fected individuals are at increased risk of developing ADIs overall, our analysis suggests that behavioral variables associated with HCV (including rates of retention on HAART), and not biological interactions with HCV itself, are primarily responsible.
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Affiliation(s)
- J Raboud
- University Health Network, Toronto, Canada
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Perera M, Tsang PCS, Samaranayake L, Lee MP, Li P. Prevalence of oral mucosal lesions in adults undergoing highly active antiretroviral therapy in Hong Kong. ACTA ACUST UNITED AC 2012; 3:208-14. [DOI: 10.1111/j.2041-1626.2012.00124.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
OBJECTIVE To describe incidence of immune reconstitution inflammatory syndrome (IRIS) and its association with mortality in a large multisite US HIV-infected cohort applying an objective, comprehensive definition. DESIGN We studied 2,610 patients seen during 1996-2007 who initiated or resumed highly active combination antiretroviral therapy (cART) and, during the next 6 months, demonstrated a decline in plasma HIV-RNA viral load of at least 0.5 log(10) copies/ml or an increase of at least 50% in CD4 cell count per microliter. We defined IRIS as the diagnosis of a type B or C condition [as per the Centers for Disease Control and Prevention (CDC) 1993 AIDS case definition] or any new mucocutaneous disorder during this same 6-month period. METHODS We assessed the incidence of IRIS and evaluated risk factors for IRIS using conditional logistic regression and for all-cause mortality using proportional hazards models. RESULTS We identified 370 cases of IRIS (in 276 patients). Median and nadir CD4 cell counts at cART initiation were 90 and 43 cells/μl, respectively; median viral load was 2.7 log(10) copies/ml. The most common IRIS-defining diagnoses were candidiasis (all forms), cytomegalovirus infection, disseminated Mycobacterium avium intracellulare, Pneumocystis pneumonia, varicella zoster, Kaposi's sarcoma and non-Hodgkin lymphoma. Only one case of Mycobacterium tuberculosis was observed. IRIS was independently associated with CD4 cell count less than 50 cells/μl vs. at least 200 cells/μl [odds ratio (OR) 5.0] and a viral load of at least 5.0 log(10) copies vs. less than 4.0 log(10) copies (OR 2.3). IRIS with a type B-defining or type C-defining diagnosis approximately doubled the risk for all-cause mortality. CONCLUSION In this large US-based HIV-infected cohort, IRIS occurred in 10.6% of patients who responded to effective ART and contributed to increased mortality.
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Kamulegeya A, Okello SM. Ranulas: possible signs for HIV/AIDS? 1 year Ugandan descriptive study. Acta Odontol Scand 2012; 70:149-53. [PMID: 21780970 DOI: 10.3109/00016357.2011.600709] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
INTRODUCTION Certain oral manifestations signal progression of HIV disease among HAART naïve patients or an increase in the plasma HIV-1 RNA levels for those on treatment. Ranulas may be one of those manifestations. Therefore, this study describes the clinical features of patients who presented with ranulas including their demographics, HIV sero-status and the CD4 CD8 cell counts for those who were HIV positive. METHODS A prospective study on ranulas was undertaken at Mulago national referral hospital and St Mary's hospital Lacor covering the period December 2008 to November 2009. RESULTS Fifty-seven cases participated in the study: 38.6% male and 61.4% female. Out of the study group, 73.7% were HIV positive. This was statistically significant (Chi = 12.789, df = 1, p = 0.001). In relation, to CD4 cell count, 23.8% had <200 cells/mm(3), 35.7% between 200-500 cells/mm(3) and 40.5% more than 500 cells/mm(3). The CD4-to-CD8 ratio ranged from 0.02-0.98 with an average of 0.31 ± 0.23, median and mode of 0.27 and 0.32, respectively. CONCLUSIONS It is felt that ranulas may be one of the oral manifestations of worsening immunity in HIV/AIDS disease. Therefore, more research is needed to establish if it should be included among known oral manifestations of the disease.
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Ramirez-Amador V, Nittayananta W, Magalhães M, Flint S, Peters B, Tappuni A. Clinical Markers of Immunodeficiency and Mechanism of Immune Reconstitution Inflammatory Syndrome and Highly Active Antiretroviral Therapy on HIV. Adv Dent Res 2011; 23:165-71. [DOI: 10.1177/0022034511400080] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Antiretroviral therapy (ART) has improved survival and changed the disease pattern of HIV infection. However, ART may cause serious side effects, such as metabolic and cardiovascular complications. In addition, immune reconstitution inflammatory syndrome (IRIS) is being increasingly reported in relation to ART. The article presents the consensus of a workshop around 4 key issues: (1) the differences in the response of adults and children to highly active antiretroviral therapy, (2) the mechanism of the new HIV entry inhibitors and its effect on oral markers, (3) the pathogenesis of IRIS and the contradictory findings of the possible oral lesions related with IRIS, (4) and the benefits and barriers associated with using ART in the developing and developed world. The consensus of the workshop was that there is a need for future studies on the oral manifestations of HIV in individuals treated with new ARTs—especially, children. IRIS was considered a promising field for future research; as such, workshop attendees recommended formulating an IRIS–oral lesions case definition and following strict criteria for its diagnosis.
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Affiliation(s)
- V. Ramirez-Amador
- Department of Health Sciences. Universidad Autónoma Metropolitana-Xochimilco, México City, Mexico
| | - W. Nittayananta
- Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - M. Magalhães
- Department of Oral Pathology, School of Dentistry, University of Sao Paulo, Brazil
| | - S.R. Flint
- Division of Oral and Maxillofacial Surgery, Oral Medicine and Oral Pathology, Dublin Dental School and Hospital, Trinity College, Dublin, Ireland
| | - B.S. Peters
- Academic Department of HIV Medicine, Harrison Wing, Medical Schools of King’s College London, London, UK
| | - A.R. Tappuni
- Queen Mary University of London, Barts, and the London School of Medicine and Dentistry, London, UK
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Comparative study of the effect of antiretroviral therapy on benign lymphoepithelial cyst of parotid glands and ranulas in HIV-positive patients. ACTA ACUST UNITED AC 2011; 111:205-10. [DOI: 10.1016/j.tripleo.2010.09.067] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2010] [Revised: 09/20/2010] [Accepted: 09/21/2010] [Indexed: 01/08/2023]
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Rotunda AM, Jones DH. Human immunodeficiency virus-associated lipohypertrophy (buccal fat pad lipoma-like lesions) reduced with subcutaneously injected sodium deoxycholate. Dermatol Surg 2010; 36:1348-54. [PMID: 20584039 DOI: 10.1111/j.1524-4725.2010.01638.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Adam M Rotunda
- Division of Dermatology, Department of Medicine, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California 92660, USA.
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Taiwo OO, Hassan Z. The impact of Highly Active Antiretroviral Therapy (HAART) on the clinical features of HIV - related oral lesions in Nigeria. AIDS Res Ther 2010; 7:19. [PMID: 20579347 PMCID: PMC2903493 DOI: 10.1186/1742-6405-7-19] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2010] [Accepted: 06/25/2010] [Indexed: 11/21/2022] Open
Abstract
Background This study aimed to determine the therapeutic effects of highly active anti-retroviral therapy (HAART) on the clinical presentations of HIV related oral lesions (HIV-ROLs) in an adult Nigerian population. Methods A 5 month prospective study on HAART naïve HIV positive adults recruited into the HAART program of an AIDS referral centre. HIV-ROLs were diagnosed clinically by the EEC Clearinghouse on oral problems related to HIV infection. Baseline clinical features of HIV-ROLs was documented by clinical photographs using SONY® 5.2 M Cybershot digital camera. Post HAART monthly review was conducted using clinical photographs. Results A total of 142 patients were seen. Age range was 19 - 75 years. Mean age was 35.6 ± 10.5 (SD). Eighty (56.3%) were females. Prevalence of HIV-ROLs was 43.7%. Oral candidiasis (22.4%) was the most prevalent HIV-ROL. 114 (83.2%) patients had clinical AIDS at presentation (CDC 1993). 89.4% were placed on Tenofovir/Emtricitabine +`Nevirapine, 9.9% on Tenofovir/Emtricitabine + Efavirenz. There was strong decline in the clinical features of oral candidiasis from a month of commencing HAART. Oral hairy leukoplakia was slow in responding to HAART. Parotid gland enlargement, melanotic hyperpigmentation and Kaposi's sarcoma were more persistent and had slower response to HAART. There was no clinical change noticed in linear gingival erythema. Conclusion HAART has different clinical effects on HIV related oral lesions depending on the size, duration of treatment and etiology of the lesions. HIV-ROLs of fungal origin have the fastest response to HAART. These lesions alongside immunologic parameters can be used as indicators of success or failure of antiretroviral therapy.
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Briggs A, Kinghorn GR. Nodular herpes simplex virus-1-positive oral lesions as a manifestation of immune reconstitution inflammatory syndrome. Int J STD AIDS 2010; 21:377-8. [DOI: 10.1258/ijsa.2010.010002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
We describe a case of nodular oral herpes simplex virus-1-positive lesions consistent with immune reconstitution inflammatory syndrome in a patient recently commenced on treatment for tuberculosis and HIV co-infection.
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Affiliation(s)
- A Briggs
- Department of Genitourinary Medicine, Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2JF, UK
| | - G R Kinghorn
- Department of Genitourinary Medicine, Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2JF, UK
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Tsang CSP, Samaranayake LP. Immune reconstitution inflammatory syndrome after highly active antiretroviral therapy: a review. Oral Dis 2010; 16:248-56. [DOI: 10.1111/j.1601-0825.2009.01628.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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