Effect of PI-HAART on the prevalence of oral lesions in HIV-1 infected patients. A Greek study.
OBJECTIVE
To investigate the association between the prevalence of oral lesions and highly active antiretroviral therapy (HAART) including a protease inhibitor (PI).


METHODS
Prospective study.


METHODS
Ninety-five consecutive patients, attending an AIDS Unit, in Greece entered the study. Fourty-four patients were receiving PI- HAART, 14 patients were on double antiretroviral therapy, and 37 patients were not receiving antiretroviral therapy at the time of oral examination. Oral lesions were diagnosed by established presumptive clinical criteria.


METHODS
Oral lesions were scored. CD4 counts and viral load were determined and related to the prevalence of oral lesions.


RESULTS
Oral lesions, and specifically oral candidiasis, were significantly reduced (P < 0.001) in patients receiving PI-HAART. Oral lesions were significantly increased in patients with CD4 counts <200 cells microl(-1) and viral load >20,000 copies ml(-1) (P < 0.001). The percentage of patients, with lesions on PI-HAART, and with CD4 < 200 and viral load >20,000 was 1.5 times lower (37.5%vs 58.8%, P < 0.001) than that of patients not receiving antiretroviral therapy, but with similar immune and viremic status.


CONCLUSIONS
Oral lesions were significantly reduced in patients on PI-HAART. A direct anticandidal effect of PI was suggestive and seemed to have accounted, beyond the HAART-related immune reconstitution, for the reduction of candidiasis and all other oral lesions.
Nicolatou-Galitis
O
O
Department of Oral Pathology and Oral Medicine, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece. nicolatou.galitis@lycos.com
Velegraki
A
A
Paikos
S
S
Economopoulou
P
P
Stefaniotis
T
T
Papanikolaou
I S
IS
Kordossis
T
T
D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D002180:Candidiasis, Oral / Q000145:classification / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D006115:Greece; D015658:HIV Infections / Q000188:drug therapy*; D017320:HIV Protease Inhibitors / Q000627:therapeutic use*; D015497:HIV-1; D006801:Humans; D017733:Leukoplakia, Hairy / Q000517:prevention & control; D008297:Male; D009059:Mouth Diseases / Q000517:prevention & control*; D011446:Prospective Studies; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use; D019562:Viral Load
D044966:Anti-Retroviral Agents; D017320:HIV Protease Inhibitors; D018894:Reverse Transcriptase Inhibitors