Oral lesions frequency in HIV-positive patients at a tertiary hospital, Southern Brazil

Peppes, Cristiane Pedroso; Lemos, Ana Silvia Pavani; Araujo, Renata Lins Fuente; Portugal, Magda Eline Guerrart; Buffon, Marilene da Cruz Magalhães; Raboni, Sonia Mara

Abstract

AIM: To report the frequency of oral lesions in HIV-positive patients on Highly Active Antiretroviral Therapy (HAART), comparing with a non-HIV infected control group, and to correlate the presence of lesions with demographic and clinical features of HIV-seropositive patients. METHODS: A quantitative case-control study was conducted by a dental professional, using a questionnaire, analysis of medical records of patients and clinical examinations. RESULTS: According to the results, oral lesions were found in 23% of HIV-positive patients versus 5% in controls. Candidiasis (29%) and periodontal changes (25%) were the most frequent oral lesions found in these patients. Gender and viral load values were statistically significant when HIV-positive patients with and without oral lesions were compared. CONCLUSIONS: The results showed a change in lesion pattern of HIV patients on HAART, highlighting a high frequency of these new lesions and reinforcing the need for periodic dental evaluation of HIV-positive patients.

HIV; bacterial infections; candidiasis; opportunist infections

¹
Brazil, Brazilian Ministry of Health, Division of Health Surveillance, National Program on STD/AIDS. Epidemiologic Bulletin AIDS [internet]. [Accessed 2012 Jun 28] Available from: http://aids.gov.br/publicacao/2011/boletim_epidemiologico_2011
²
Chagas MV, Santos LO, Ono LM. Oral manifestations in HIV patients treated at the Tropical Medicine Foundation of Amazonas (FMT-AM). Rev Fac Odontol Porto Alegre. 2009; 50: 10-13.
³
Perera M, Tsang PC, Samaranayake L, Lee MP Prevalence of oral mucosal lesions in adults undergoing highly active antiretroviral therapy in Hong Kong. J Investig Clin Dent. 2012; 3: 208-14.
⁴
Watanuki F. Oral manifestations associated with HIV after 30 years of the epidemic in Brazil [dissertation]. São Paulo, SP, BR: Faculty of Dentistry, University of São Paulo; 2010. 115 p.
⁵
Tamí-Maury IM, Willig JH, Jolly PE, Vermund S, Aban I, Hill JD, et al. Prevalence, incidence, and recurrence of oral lesions among HIV-infected patients on HAART in Alabama: a two-year longitudinal study. South Med J 2011; 104: 561–6.
⁶
Khatibi M, Moshari AA, Jahromi ZM, Ramezankhani A. Prevalence of oral mucosal lesions and related factors in 200 HIV+/AIDS Iranian patients. J Oral Pathol Med. 2011; 40: 659-64.
⁷
Dias CF, Nunes CC, Freitas IO, Lamego IS, Oliveira IM, Gilli S, et al. High prevalence and association of HIV-1 non-B subtype with specific sexual transmission risk among antiretroviral naïve patients in Porto Alegre, RS, Brazil. Rev Inst Med Trop Sao Paulo. 2009; 51: 191-6.
⁸
Brazil. HIV, AIDS and Viral hepatitis Department. [internet]. [Accessed 2012 Jun 21] Available from: http://www.aids.gov.br/aids
⁹
Nittayananta W, Chanowanna N, Winn T, Silpapojakul K, Rodklai A, Jaruratanasirikul S, et al. Co-existence between oral lesions and opportunistic systemic diseases among HIV-infected subjects in Thailand. J Oral Pathol Med. 2002; 31: 163-8.
¹⁰
Chopra S, Arora U. Skin and Mucocutaneous Manifestations: Useful Clinical Predictors of HIV/AIDS. J Clin Diagn Res. 2012; 6: 1695-8.
¹¹
Shirlaw PJ, Chikte U, MacPhail L, Schmidt-Westhausen A, Croser D, Reichart P. Oral and dental care and treatment protocols for the management of HIV-infected patients. Oral Dis. 2002; 8: 136-43.
¹²
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; 3: 1-18
¹³
Mataftsi M, Skoura L, Sakellari D. HIV infection and periodontal diseases: an overview of the post-HAART era. Oral Dis. 2011; 17: 13-25.
¹⁴
Mariano BMF. Periodontal disease and oral lesions in the population HIV / AIDS referral center, control and treatment of the Military Police of Minas Gerais [dissertation]. Minas Gerais, MG, BR: Federal University of Minas Gerais; 2008. 169 p.
¹⁵
Alpagot T, Duzgunes N, Wolff LF, Lee A. Risk factors for periodontitis in HIV patients. J Periodont Res. 2004; 39: 149-57.
¹⁶
Scheutz F, Matee MI, Andsager L, Holm AM, Moshi J, Kagoma C, et al. Is there an association between periodontal conditions and HIV infection? J Clin Periodontol. 1997; 24: 580-7.
¹⁷
Vastardis SA, Yukna RA, Fidel PL Jr, Leigh JE, Mercante DE. Periodontal disease in HIV-positive individuals: association of periodontol indices with stages of HIV disease. J Periodontol. 2003; 74: 1336-41.
¹⁸
Laskaris G, Madjivassilion M, Stratigos J. Oral signs and symptoms in a 60 Greek HIV infected patients. J Oral Pathol Med. 1992; 21: 120-3.
¹⁹
Adurogbangba MI, Aderinokun GA, Odaibo GN, Olaleye OD, Lawoyin TO. Oro-facial lesions and CD4 counts associated with HIV/AIDS in an adult population in Oyo State, Nigeria. Oral Dis. 2004; 10: 319-26.
²⁰
Sharma G, Pai KM, Suhas S, Ramapuram JT, Doshi D, Anup N. Oral manifestations in HIV/AIDS infected patients from India. Oral Dis. 2006; 12: 537-42.
²¹
Bendick C, Scheifele C, Reichart PA 2002. Oral manifestations in 101 Cambodian patients with HIV infection and AIDS. J Oral Pathol Med. 2002; 31: 1-4.
²²
Challacombe SJ, Coogan NN, Williams DN. Overview of the fourth international workshop on the oral manifestations of HIV infection. Oral Dis. 2002; 8: 9-14.
²³
Owotade FJ, Shiboski CH, Poole L, Ramstead CA, Malvin K, Hecht FM, et al. Prevalence of oral disease among adults with primary HIV infection. Oral Dis. 2008; 14: 497-9.
²⁴
Zhang X, Reichart PA, Song Y. Oral manifestations of HIV/AIDS in China: a review. J Oral Maxillofac Surg. 2009; 13: 63-8.
²⁵
Eyeson JD, Tenant-Flowers M, Cooper DJ, Johnson NW, Warnakulasuriya KA. Oral manifestations of an HIV positive cohort in the era of highly active anti-retroviral therapy (HAART) in South London. J Oral Pathol Med. 2002; 31: 169-74.
²⁶
Yengopal V, Naidoo S. Oral lesions associated with HIV affect quality of life? Oral Surg, Oral Med, Oral Pathol, Oral Radiol Endod. 2008; 106: 66-73.

Publication Dates

Publication in this collection
28 Oct 2013
Date of issue
Sept 2013

History

Received
15 May 2013
Accepted
11 Sept 2013

This work is licensed under a Creative Commons Attribution 4.0 International License.

[1] ¹
Brazil, Brazilian Ministry of Health, Division of Health Surveillance, National Program on STD/AIDS. Epidemiologic Bulletin AIDS [internet]. [Accessed 2012 Jun 28] Available from: http://aids.gov.br/publicacao/2011/boletim_epidemiologico_2011

[2] ²
Chagas MV, Santos LO, Ono LM. Oral manifestations in HIV patients treated at the Tropical Medicine Foundation of Amazonas (FMT-AM). Rev Fac Odontol Porto Alegre. 2009; 50: 10-13.

[3] ³
Perera M, Tsang PC, Samaranayake L, Lee MP Prevalence of oral mucosal lesions in adults undergoing highly active antiretroviral therapy in Hong Kong. J Investig Clin Dent. 2012; 3: 208-14.

[4] ⁴
Watanuki F. Oral manifestations associated with HIV after 30 years of the epidemic in Brazil [dissertation]. São Paulo, SP, BR: Faculty of Dentistry, University of São Paulo; 2010. 115 p.

[5] ⁵
Tamí-Maury IM, Willig JH, Jolly PE, Vermund S, Aban I, Hill JD, et al. Prevalence, incidence, and recurrence of oral lesions among HIV-infected patients on HAART in Alabama: a two-year longitudinal study. South Med J 2011; 104: 561–6.

[6] ⁶
Khatibi M, Moshari AA, Jahromi ZM, Ramezankhani A. Prevalence of oral mucosal lesions and related factors in 200 HIV+/AIDS Iranian patients. J Oral Pathol Med. 2011; 40: 659-64.

[7] ⁷
Dias CF, Nunes CC, Freitas IO, Lamego IS, Oliveira IM, Gilli S, et al. High prevalence and association of HIV-1 non-B subtype with specific sexual transmission risk among antiretroviral naïve patients in Porto Alegre, RS, Brazil. Rev Inst Med Trop Sao Paulo. 2009; 51: 191-6.

[8] ⁸
Brazil. HIV, AIDS and Viral hepatitis Department. [internet]. [Accessed 2012 Jun 21] Available from: http://www.aids.gov.br/aids

[9] ⁹
Nittayananta W, Chanowanna N, Winn T, Silpapojakul K, Rodklai A, Jaruratanasirikul S, et al. Co-existence between oral lesions and opportunistic systemic diseases among HIV-infected subjects in Thailand. J Oral Pathol Med. 2002; 31: 163-8.

[10] ¹⁰
Chopra S, Arora U. Skin and Mucocutaneous Manifestations: Useful Clinical Predictors of HIV/AIDS. J Clin Diagn Res. 2012; 6: 1695-8.

[11] ¹¹
Shirlaw PJ, Chikte U, MacPhail L, Schmidt-Westhausen A, Croser D, Reichart P. Oral and dental care and treatment protocols for the management of HIV-infected patients. Oral Dis. 2002; 8: 136-43.

[12] ¹²
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; 3: 1-18

[13] ¹³
Mataftsi M, Skoura L, Sakellari D. HIV infection and periodontal diseases: an overview of the post-HAART era. Oral Dis. 2011; 17: 13-25.

[14] ¹⁴
Mariano BMF. Periodontal disease and oral lesions in the population HIV / AIDS referral center, control and treatment of the Military Police of Minas Gerais [dissertation]. Minas Gerais, MG, BR: Federal University of Minas Gerais; 2008. 169 p.

[15] ¹⁵
Alpagot T, Duzgunes N, Wolff LF, Lee A. Risk factors for periodontitis in HIV patients. J Periodont Res. 2004; 39: 149-57.

[16] ¹⁶
Scheutz F, Matee MI, Andsager L, Holm AM, Moshi J, Kagoma C, et al. Is there an association between periodontal conditions and HIV infection? J Clin Periodontol. 1997; 24: 580-7.

[17] ¹⁷
Vastardis SA, Yukna RA, Fidel PL Jr, Leigh JE, Mercante DE. Periodontal disease in HIV-positive individuals: association of periodontol indices with stages of HIV disease. J Periodontol. 2003; 74: 1336-41.

[18] ¹⁸
Laskaris G, Madjivassilion M, Stratigos J. Oral signs and symptoms in a 60 Greek HIV infected patients. J Oral Pathol Med. 1992; 21: 120-3.

[19] ¹⁹
Adurogbangba MI, Aderinokun GA, Odaibo GN, Olaleye OD, Lawoyin TO. Oro-facial lesions and CD4 counts associated with HIV/AIDS in an adult population in Oyo State, Nigeria. Oral Dis. 2004; 10: 319-26.

[20] ²⁰
Sharma G, Pai KM, Suhas S, Ramapuram JT, Doshi D, Anup N. Oral manifestations in HIV/AIDS infected patients from India. Oral Dis. 2006; 12: 537-42.

[21] ²¹
Bendick C, Scheifele C, Reichart PA 2002. Oral manifestations in 101 Cambodian patients with HIV infection and AIDS. J Oral Pathol Med. 2002; 31: 1-4.

[22] ²²
Challacombe SJ, Coogan NN, Williams DN. Overview of the fourth international workshop on the oral manifestations of HIV infection. Oral Dis. 2002; 8: 9-14.

[23] ²³
Owotade FJ, Shiboski CH, Poole L, Ramstead CA, Malvin K, Hecht FM, et al. Prevalence of oral disease among adults with primary HIV infection. Oral Dis. 2008; 14: 497-9.

[24] ²⁴
Zhang X, Reichart PA, Song Y. Oral manifestations of HIV/AIDS in China: a review. J Oral Maxillofac Surg. 2009; 13: 63-8.

[25] ²⁵
Eyeson JD, Tenant-Flowers M, Cooper DJ, Johnson NW, Warnakulasuriya KA. Oral manifestations of an HIV positive cohort in the era of highly active anti-retroviral therapy (HAART) in South London. J Oral Pathol Med. 2002; 31: 169-74.

[26] ²⁶
Yengopal V, Naidoo S. Oral lesions associated with HIV affect quality of life? Oral Surg, Oral Med, Oral Pathol, Oral Radiol Endod. 2008; 106: 66-73.

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Oral lesions frequency in HIV-positive patients at a tertiary hospital, Southern Brazil

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