Prevalence of Oral Lesions in AIDS and HIV Positive Patients

Objectives: Oral lesions are common in HIV infected patients. Several studies have been conducted in order to determine the prevalence of oral lesions in AIDS/HIV infected patients. Since few studies have been conducted in this issue in Iran, the current study aimed at evaluating the prevalence of oral lesions relating to HIV/AIDS in patients referring to Imam Khomeini Hospital. The presence of oral lesions was correlated with biologic and behavioral risk factors. Methods: 203 patients with AIDS/HIV+ were recruited in this study and oral examination was performed for each individual. The oral lesions were diagnosed based on clinical appearance using EEC-Clearing house criteria on oral problems related to HIV infection (1993). Oral lesions were managed by routine therapeutic protocols. Results: 77.3% patients were male. 186 oral lesions were diagnosed in association with HIV in 109 patients (53%). The most common oral lesions were Erythematous Candidiasis (24.1%), Angular Cheilitis (22.2%), Hyperpigmentation (18.2%), and Pseudomembranous Candidiasis (14.3%) respectively. Other oral lesions which were seen included: Hairy Leucoplakia (3.4%), Herpes Labialis (3.4%), Hyperplastic Candidiasis (2.5%), Minor Aphthous ulcers (1.5%), common Wart (1 case), Facial palsy (1 case), and Steven Johnson disease (1 case). Smoking addicted participants and patients using mobile dental prosthesis were more likely to have oral candidiasis. Patients who were on HAART had a significantly lower risk of pseudomembranous candidiasis. No significant relationship was found between use of HAART and presence of oral pigmentation. Pseudomembranous Candidiasis was significantly associated with AIDS condition. Conclusions: The prevalence of oral HIV lesions in the present study was high. A comprehensive oral examination plays an important role not only in the management of the patients, but also in assessing the immune status and their follow-up. There are many biological and behavioral risk factors that influence the development of oral lesions in AIDS/HIV+ patients.