Prevalence and incidence of oral lesions--the changing scene.
A range of oral mucosal and periodontal lesions is associated with HIV infection and HIV disease progression. These are often symptomatic and require treatment in themselves, and also have a diagnostic and prognostic role in the management of the underlying HIV disease. These lesions have been broadly divided into: (a) those strongly associated with HIV such as oral candidoses, oral hairy leukoplakia and Kaposi's sarcoma; (b) those less strongly associated such as swellings of the major salivary glands; and (c) those least commonly associated such as recurrent aphthous ulcers. Overall the prevalence and severity of these lesions inversely correlate with the level of immunosuppression. With the passage of time, there has been improved understanding of the disease pathogenesis resulting in the development of new drugs to combat this infection. Medication has changed from monotherapy to current triple combination therapy (Highly Active Anti-Retroviral Therapy). This review looks at the impact of changing therapy on the prevalence of the various oral lesions associated with HIV. It finds a decrease in the prevalence of the oral lesions in the era of combination therapy as compared to earlier periods. It also shows a change in the types of lesions which predominate with those previously placed amongst the strongly associated lesions no longer being predominant in the era of combination therapy where such treatment is available.
Eyeson
J D
JD
Department of Oral and Maxillofacial Medicine and Pathology, Guy's, King's and St Thomas' Dental Institute, Denmark Hill Campus, Caldecot Road, London SE5 9RW, UK.
Warnakulasuriya
K A
KA
Johnson
N W
NW
D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology; D023241:Antiretroviral Therapy, Highly Active; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000276:immunology; D006801:Humans; D007108:Immune Tolerance; D015994:Incidence; D009059:Mouth Diseases / Q000453:epidemiology*; D015995:Prevalence