The Significance of Oral Lesions in HIV/AIDS

Oral lesions are common in HIV infected individuals. All patients in the study group had oral lesions. In order of prevalence the commonest lesions we have seen are: Angular cheilitis (61.82%), Hyperpigmentation (52.73%), Lymphadenopathy (47.27%), Xerostomia (40.91%), Pseudomembranous candidiasis (39.09%), Gingivitis (37.27%), Salivary gland enlargement (34.55%), Erythematous candidiasis (28.18%), Fissured tongue(19.09%), Necrotising gingivitis (12.73%), Oral hairy leukoplakia (10.91%), Linear gingivitis (12.73%), Depapillation of Tongue (09.09%), Necrotising ulcerative periodontitis (08.18%), Apthous ulcer (05.45%), Herpes labialis (05.45%), Viral wart (04.56%), Herpes simplex infection (03.64%),Oral lymphoma (03.64%), Squamous cell carcinoma(01.82%), OSMF (1.82%), Oral leukoplakia (01.82%), Herpes zoster (0.91%). Multiple lesions are frequently seen in these patients. 48.18% of patients had 3 to 4 lesions concurrently. 63.83% of patients who were on ART had more than 5 lesions at a time in comparison to 28.57% in pre ART group. Multiple lesions were common between the age group of 31 to 50. Smoking and Tobacco chewing also favour multiple lesions. More than 5 lesions were seen in 23.73% of smokers and 21.15% of tobacco chewers. Lesions subside with standard treatment regimens suggested by NACO. Oral hygiene and nutritional counseling helps in recurrence of most of the infective lesions. Proper counseling regarding oral hygiene, nutrition and habits like smoking, chewing tobacco will prevent in the recurrence. Very extensive atypical clinical pattern of pseudomembranous candidiasis, oral ulcers were observed. It takes longer time for the lesions to subside in pre ART group. Double blind, multicentric trials can be conducted in India, to test the above findings. Longitudinal studies can be conducted to follow up these patients over a period of time to ascertain the prognostic values of common oral lesions for immune suppression. Use of definitive criteria for diagnosis of oral lesions in future studies